TEST BANK for Introduction to Communication Disorders A Lifespan Evidence-Based Perspective 7th Edit

TEST BANK TEST BANK

TEST BANK TEST BANK

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TEST BANK for Introduction to Communication Disorders A Lifespan EvidenceBased Perspective 7th Edition by Robert Owens & Kimberly Farinella Chapter 1-13

Introduction to Communication Disorders A Lifespan Evidence-Based Perspective

Seventh Edition

Dr. Robert E. Owens, College of St. Rose Dr. Kimberly A. Farinella, Northern Arizona University

Prepared by

Dr. Sarah A. Dachtyl

Section 1.01

Table of Contents

Chapter 1: The Field, the Professionals, and the Clients

1

Learning Objective Quizzes

1

Application Exercises

10

Test Items

13

Test Answer Key

17

Section 1.02 Chapter 1: The Field, the Professionals, and the Clients (a) Chapter 1 Learning Objective Quizzes Learning Outcome 1.1: Describe communication disorders.

[Q1] A transgender individual elects to modify her voice and works with a speech-language pathologist. Which of the following is most likely true?

1. The client has a speech disorder 2. The client has a language disorder 3. The client does not have a communication disorder [correct] 4. The client requires an augmentative communication system [Feedback for Answer Choice 1] Transgender clients electing to modify their voices to match their identity do not have speech disorders.

[Feedback for Answer Choice 2] Transgender clients electing to modify their voices to match their identity do not have language disorders.

[Feedback for Correct Answer 3] Transgender clients electing to modify their voices to match their identity do not have communication disorders. They may receive the services of a speech-language pathologist, however.

[Feedback for Answer Choice 4]

Transgender clients electing to modify their voices to match their identity do not require an augmentative communication system.

[Q2] Mr. Martinez experiences difficulty swallowing after his stroke.

Janessa lives in Tucson, Arizona and demonstrates dialectal differences consistent with her home region of Nogales, Mexico.

Anthony was diagnosed with a profound bilateral hearing loss.

Which of the following clients exhibits a disorder for which a speech-language pathologist or audiologist might treat?

1. Only Mr. Martinez 2. Only Janessa 3. Anthony and Janessa 4. Mr. Martinez and Anthony [correct] [Feedback for Answer Choice 1] Mr. Martinez demonstrates a swallowing disorder secondary to his stroke. Speechlanguage pathologists are involved in treatment of swallowing disorders.

[Feedback for Answer Choice 2] Dialectal differences are not communication disorders.

[Feedback for Answer Choice 3] Janessa demonstrates a dialectal difference, which is not a communication disorder.

[Feedback for Correct Answer 4] Mr. Martinez demonstrates a swallowing disorder secondary to his stroke. Speechlanguage pathologists are involved in treatment of swallowing disorders. Anthony was diagnosed with a profound bilateral hearing loss. Audiologists and/or speech-language pathologists are involved in treatment of hearing disorders.

[Q3] Jaime demonstrates an impairment in the use of written symbol systems. Which of the following does he demonstrate?

1. A communication difference; not a disorder 2. A central auditory processing disorder 3. A speech disorder 4. A language disorder [correct] [Feedback for Answer Choice 1]

An impairment in comprehension or use of written symbol systems is a language disorder.

[Feedback for Answer Choice 2] An impairment in comprehension or use of written symbol systems is a language disorder. A central auditory processing disorder is a deficit in processing of information from audible signals.

[Feedback for Answer Choice 3] An impairment in comprehension or use of written symbol systems is a language disorder. A speech disorder refers to atypical production of speech sounds, interruption in the flow of speaking, or abnormal production and/or absences of voice quality.

[Feedback for Correct Answer 4] An impairment in comprehension or use of written symbol systems is a language disorder.

Learning Outcome 1.2: Discuss the roles of audiologists, speech-language pathologists, and speech, language, and hearing scientists.

[Q1] Which of the following individuals has completed the minimum requirements to become an audiologist?

1. Ashley has completed a P hD in audiology, has completed an internship with a major tech company, and has applied for membership with A SHA 2. Idris has completed his master‟s degree in audiology and speech sciences, has completed his internship, and has applied for membership with ASHA 3. Pau has completed his A uD, professional experience, and has applied for state licensure 4. Kim has completed her AuD, professional experience, and passed her national exam [correct] [Feedback for Answer Choice 1] Ashley has not passed the national exam and it is unclear what her tech internship entailed.

[Feedback for Answer Choice 2] Idris has not passed the national exam and he has not earned a doctoral degree in audiology.

[Feedback for Answer Choice 3] Pau has not passed the national exam.

[Feedback for Correct Answer 4]

Kim has fulfilled the credentials for audiologists, including a doctoral degree in audiology, professional experience, and passing of a national exam. Depending on where she works, a state license may also be needed.

[Q2] Which of the following individuals has completed the minimum requirements to become a speech-language pathologist?

1. Nissa has completed a master‟s degree in communication sciences and disorders, has passed a national qualifying exam, and has secured an internship 2. Javier has completed a doctoral degree in communication sciences and disorders, has passed a national qualifying exam, and has secured an internship 3. Amaya has completed a doctoral degree in communication sciences and disorders, has completed her clinical fellowship year, and has applied for membership with AS HA 4. Remi has completed a master‟s degree in communication sciences and disorders, has completed his clinical fellowship year, and passed a national qualifying exam [correct] [Feedback for Answer Choice 1] Nissa has not completed her clinical fellowship year.

[Feedback for Answer Choice 2] Javier has not completed his clinical fellowship year. A doctoral degree is not required to become a speech-language pathologist and so it is not considered a minimum requirement.

[Feedback for Answer Choice 3] Amaya has not passed a national qualifying exam. A doctoral degree is not required to become a speech-language pathologist and so it is not considered a minimum requirement.

[Feedback for Correct Answer 4] Remi has completed the minimum requirements required to become a speech-language pathologist. Depending on where he works, a state license may also be needed.

[Q3] Which of the following professionals is most likely a speech scientist?

1. Arthur has a master‟s degree in speech-language pathology and specializes in treating motor speech disorders within his private practice setting 2. Elizabeth has a doctoral degree and works to develop computer-generated speech for individuals who have lost their natural speech due to amyotrophic lateral sclerosis [correct]

3. Santiago has a doctoral degree and studies how language disorders affect quality of life and community participation for individuals who have been diagnosed with aphasia after stroke 4. Mia has a bachelor‟s degree and works with a speech-language pathologist to provide treatment exclusively to children with speech sound disorders [Feedback for Answer Choice 1] Arthur is working clinically rather than as a scientist. There is no indication within Arthur‟s description that he conducts research or develops technology.

[Feedback for Correct Answer 2] Elizabeth has a doctoral degree and develops technology relevant to speech disorders.

[Feedback for Answer Choice 3] Santiago is a language scientist.

[Feedback for Answer Choice 4] Based on this description, Mia is a speech-language pathology assistant.

Learning Outcome 1.3: Explain how intervention services change through the lifespan.

[Q1] Which of the following children is experiencing the most common disabling condition for children born in the United States?

1. Diego was identified with a visual impairment shortly after birth 2. Carlos was identified with physical problems that limited his movement at birth 3. Gina sustained a traumatic brain injury at birth 4. Daniel was born with a hearing loss [correct] [Feedback for Answer Choice 1] Although babies and toddlers may have visual impairments, hearing loss occurs more often than any other physical problem.

[Feedback for Answer Choice 2] Although babies and toddlers may have physical problems that limit their movement, hearing loss occurs more often than any other physical problem.

[Feedback for Answer Choice 3] Although babies and toddlers may sustain traumatic brain injuries at birth, hearing loss occurs more often than any other physical problem.

[Feedback for Correct Answer 4] For children born in the United States, hearing loss occurs more often than any other physical problem.

[Q2] Which of the following statements shows support for this statement: Early intervention is highly valuable and may prevent later difficulties.

1. Alex is 2 years old. His family physician prefers a “wait and see” approach to language development and encourages the family to contact his school once he reaches kindergarten if they continue to believe he is having difficulty communicating 2. Viviana is 1 year, 9 months old. Her team has developed an individualized family service plan to support her needs related to her developmental disability and also includes supports for her entire family [correct] 3. Jacob is 2 years, 3 months old. His physician makes a referral because he is not meeting developmental milestones, but the family declines 4. Jesus is 2 years, 6 months old. His family knows that he will “grow out” of the concerns that others have brought up to them, including delayed speech, motor impairment, and lack of engagement with others [Feedback for Answer Choice 1] Waiting until a child attains/reaches school age is not providing early intervention.

[Feedback for Correct Answer 2] Viviana‟s team provided individualized supports for her and her family early in life.

[Feedback for Answer Choice 3] The family elected not to follow through on early intervention services recommended by the physician.

[Feedback for Answer Choice 4] Waiting for a child to “grow out” of communication and motor concerns is not providing early intervention.

[Q3] Hearing loss affects what percentage of older adults?

1. Hearing loss affects approximately 15% of older adults 2. Hearing loss affects less than 5% of older adults 3. Hearing loss affects at least 25% of older adults [correct] 4. Hearing loss affects 10% of older adults [Feedback for Answer Choice 1] Hearing loss affects at least 25% of older adults.

[Feedback for Answer Choice 2] Hearing loss affects at least 25% of older adults.

[Feedback for Correct Answer 3]

Hearing loss affects at least 25% of older adults.

[Feedback for Answer Choice 4] Hearing loss affects at least 25% of older adults.

Learning Outcome 1.4: Describe how evidence-based practice influences clinical decisions.

[Q1] Which speech-language pathologist (SLP) is most closely following principles of evidence-based practice?

1. Eleonora makes sure to follow social media posts of social media influencers as this is an efficient way for her to learn more information 2. Josiah understands that the field of speech-language pathology is slow to evolve, so he makes sure to continue to use the strategies he learned in graduate school 11 years ago 3. Victoria frequently seeks out new information regarding therapy techniques and reviews relevant meta-analyses when they are released [correct] 4. John realizes that research studies do not translate to clinical practice and instead seeks information from private vendors [Feedback for Answer Choice 1] Professional, peer-reviewed journals are the best source of clinical evidence. In studies employing meta-analysis, research on a topic is ranked according to the strength of the data and then examined to see the statistical trends.

[Feedback for Answer Choice 2] The expert SLP or audiologist continually seeks new therapeutic information to improve efficacy.

[Feedback for Correct Answer 3] Professional, peer-reviewed journals are the best source of clinical evidence. In studies employing meta-analysis, research on a topic is ranked according to the strength of the data and then examined to see the statistical trends.

[Feedback for Answer Choice 4] Professional, peer-reviewed journals are the best source of clinical evidence. In studies employing meta-analysis, research on a topic is ranked according to the strength of the data and then examined to see the statistical trends.

[Q2] Effectiveness is the probability that a treatment will work under what type of conditions?

1. Optimal conditions 2. Laboratory conditions

3. Average conditions [correct] 4. Controlled research conditions [Feedback for Answer Choice 1] Efficacy is the probability of benefit from an intervention under optimal intervention conditions.

[Feedback for Answer Choice 2] Effectiveness is the probability of benefit from an intervention method under average, real-world conditions.

[Feedback for Correct Answer 3] Effectiveness is the probability of benefit from an intervention method under average, real-world conditions.

[Feedback for Answer Choice 4] Effectiveness is the probability of benefit from an intervention method under average, real-world conditions.

[Q3] Clinical decision making is based on a combination of: 1. How fast progress can be made and the physician‟s prescription for specific techniques 2. Efficacious, effective, and efficient treatment techniques 3. Scientific evidence, clinical experience, and client needs [correct] 4. Meta-analyses and statistical trends [Feedback for Answer Choice 1] Clinical decision making is informed by a combination of scientific evidence, clinical experience, and client needs.

[Feedback for Answer Choice 2] Clinical decision making is informed by a combination of scientific evidence, clinical experience, and client needs.

[Feedback for Correct Answer 3] Clinical decision making is informed by a combination of scientific evidence, clinical experience, and client needs.

[Feedback for Answer Choice 4] Clinical decision making is informed by a combination of scientific evidence, clinical experience, and client needs.

Learning Outcome 1.5: Outline the history of changing attitudes toward individuals with communication disabilities over the centuries and legislation over the past several decades. .

[Q1] The field of audiology expanded dramatically in the 1940s due to: 1. The discovery that age-related hearing loss was a significant public health concern 2. The passage of the Individuals with Disabilities Education Act (I DEA) 3. Noise-induced hearing loss experienced by veterans [correct] 4. The Civil Rights movement, which advanced the rights of those with hearing loss, as well as other populations [Feedback for Answer Choice 1] Audiology experienced a boom in the 1940s due to World War II veterans who were experiencing noise-induced hearing loss.

[Feedback for Answer Choice 2] Audiology experienced a boom in the 1940s due to World War II veterans who were experiencing noise-induced hearing loss.

[Feedback for Correct Answer 3] Audiology experienced a boom in the 1940s due to World War II veterans who were experiencing noise-induced hearing loss. The passage of IDEA occurred in 1990.

[Feedback for Answer Choice 4] Audiology experienced a boom in the 1940s due to World War II veterans who were experiencing noise-induced hearing loss. The Civil Rights movement occurred in the 1960s.

[Q2] Which law originally mandated that a free and appropriate public education must be provided for all handicapped children between ages 5 and 21?

1. Individuals with Disabilities Education Act (1990) 2. Reauthorization of the Individuals with Disabilities Education Act (2004) 3. Education of the Handicapped Amendments 4. Education for All Handicapped Children Act [correct] [Feedback for Answer Choice 1] IDEA (1990) Reauthorized and renamed the original law. It addressed the multicultural nature of the United States.

[Feedback for Answer Choice 2]

The reauthorization of IDEA (2004) established birth-6 programs as well as new early intervention services.

[Feedback for Answer Choice 3] The Education of the Handicapped Amendments extended the age of those served to cover children between birth and 5 years of age.

[Feedback for Correct Answer 4] The Education for All Handicapped Children originally mandated that a free and appropriate public education must be provided for all handicapped children between ages 5 and 21.

[Q3] Which of the following refers to a positive movement amongst those with disabilities to organize and express pride in their identity and self-advocacy?

1. Civil Rights Movement 2. Disability Rights Movement [correct] 3. American Coalition of Citizens with Disabilities 4. The Person-First Movement [Feedback for Answer Choice 1] The Civil Rights Movement began in the 1960s and was not specific to those with disabilities. The Disability Rights Movement is a positive movement amongst those with disabilities to organize and express pride in their identity and self-advocacy.

[Feedback for Correct Answer 2] The Disability Rights Movement is a positive movement amongst those with disabilities to organize and express pride in their identity and self-advocacy.

[Feedback for Answer Choice 3] The American Coalition of Citizens with Disabilities was created in 1974 and led to a variety of federal mandates. The Disability Rights Movement is a positive movement amongst those with disabilities to organize and express pride in their identity and selfadvocacy.

[Feedback for Answer Choice 4] The Person-First Movement does not exist, but some communities have recently begun advocating against person-first terminology, particularly when it pertains to autism.

(b) Chapter 1 Application Exercises Application Exercise 1.1: Role of the SLP

Learning Outcome 1.2: Discuss the roles of audiologists, speech-language pathologists, and speech, language, and hearing scientists.

Reference: Case Study: Mike (see pages 2, 19, and 20) [Q1] Use Case Study: Mike (pages 2, 19, and 20) to answer the following question: What difficulties did Mike experience?

[Q1 Model Response] Mike experienced tremor, slurred speech, difficulty swallowing, and short-term memory impairment.

[Q2] Use Case Study: Mike (pages 2, 19, and 20) to answer the following question: What strategies did his speech-language pathologist use to help him?

[Q2 Model Response] Mike‟s speech-language pathologist found that if he gripped his hand, tremors would reduce and speech and swallowing would improve.

[Q3] Use Case Study: Mike (pages 2, 19, and 20) to answer the following question: Although Mike‟s abilities declined over time, how could his case be considered successful?

[Q3 Model Response] Through therapy with his SLP, Mike was able to hold on to the communication skills he had. Because of the nature of his health condition, improvement was not expected. His quality of life was enhanced through the intervention he was provided.

Application Exercise 1.2: Description of communication and swallowing disorders and their impact Learning Outcome 1.1: Describe communication disorders.

Reference: Patient description of Ken (see italicized text on page 4) [Q1] Use patient description of Ken (see italicized text on page 4) to answer the following question: Describe Ken‟s initial symptoms of Parkinson disease.

[Q1 Model Response]

Ken initially experienced a slight muscle twitch in his hands that occurred periodically.

Over time, it become more consistent.

[Q2] Use patient description of Ken (see italicized text on page 4) to answer the following question: What were Ken‟s communication and swallowing impairments?

[Q2 Model Response] After his diagnosis of Parkinson disease, he experienced speech difficulties and dementia. This in turn affected his language and reduced him to single word utterances.

Eating and swallowing were challenging.

[Q3] Use patient description of Ken (see italicized text on page 4) to answer the following question: How did Ken‟s communication and swallowing impairments impact his family?

[Q3 Model Response] The patient description notes that after Ken retired, his home care was a family responsibility. He refused some therapeutic interventions. He was noted to never lose his sense of humor, which can be a positive factor.

Application Exercise 1.3: Evidence-based clinical decision making Learning Outcome 1.4: Describe how evidence-based practice influences clinical decisions.

Reference: Client description of Ling Yun (see italicized text on page 15) [Q1] Use client description of Ling Yun (see italicized text on page 15) to answer the following question: What was Ling Yun‟s family‟s reaction to his language disorder diagnosis?

[Q1 Model Response] His family initially blamed his preschool SLP for having a misunderstanding of cultural differences.

[Q2] Use client description of Ling Yun (see italicized text on page 15) to answer the following question: How was Ling Yun‟s SLP able to help his family understand his language disorder?

[Q2 Model Response] Ling Yun‟s SLP gained the family‟s trust by being knowledgeable about multilingual development and being sensitive to their concerns.

[Q3] Use client description of Ling Yun (see italicized text on page 15) to answer the following question: How did an understanding of evidence-based practices affect Ling Yun‟s communication outcomes?

[Q3 Model Response] If the SLP had not been knowledgeable about multilingual development, he would not have achieved the outcomes he did: After about a year and a half of speech-language therapy services, Ling Yun no longer has a language disorder.

(c) Chapter 1 Test Items 1. “Atypical production of speech sounds, interruption in the flow of speaking, or abnormal production and/or absence of voice quality” is the definition of a a. speech disorder. b. language disorder. c. hearing disorder. d. central auditory processing disorder.

2. “Impairment in comprehension and/or use of spoken, written, and/or other symbol systems” is the definition of a a. speech disorder. b. language disorder. c. hearing disorder. d. central auditory processing disorder.

3. “A result of impaired sensitivity of the auditory system” is the definition of a a. speech disorder. b. language disorder. c. hearing disorder. d. central auditory processing disorder.

4. “Deficits in the processing of information from audible signals” is the definition of a a. speech disorder.

b. language disorder. c. hearing disorder. d. central auditory processing disorder.

5. Attempts taught by SLPs to compensate and facilitate for impaired communication using various methods. a. Dialectal variation b. Autmentative/alternative communication c. Multilingualism d. Holistic approaches to evaluation 6. The professionals who measure hearing and identify, assess, manage, and prevent disorders of hearing and balance are a. audiometers. b. hearing aid dispensers. c. audiologists. d. aural rehabilitation professionals.

7. The professionals who identify, assess, treat, and prevent expressive and receptive communication disorders, as well as provide services for swallowing disorders and dialect modification are a. speech correctionists. b. speech-language pathologists. c. speech teachers. d. speech scientists.

8. The professionals who extend knowledge of human communication processes and disorders and usually hold doctorate degrees are a. audiologists. b. speech, language, and hearing scientists. c. speech-language pathologists. d. speech-language pathology assistants.

9. The entry-level degree for an audiologist is currently a. bachelor‟s degree in audiology. b. master‟s degree in audiology. c. doctoral degree (A uD, PhD, or EdD in audiology). d. associate‟s degree in audiology and speech sciences.

10. The degree required for speech-language pathologists to earn the ASHA CCC is currently a. associate‟s degree. b. bachelor's degree. c. master‟s degree. d. bachelor‟s degree plus a teaching certificate.

11. On average, in the United States, a. 1 in 7 people has a disability. b. 1 in 15 people has a disability. c. 1 in 27 people has a disability. d. 1 in 50 people has a disability.

12. Almost half of all SLPs are employed a. in school systems. b. in healthcare. c. in private practice. d. in school systems, healthcare, and private practice combined.

13. A clinician seeks to provide therapy services in a way that provides quick and maximum functional gains. Which of the following evidence-based principles is this most closely referring to? a. Effectiveness b. Efficiency c. Efficacy d. Value-based intervention 14. How many Americans sustain a traumatic brain injury each year? a. 500,000–750,000 b. 1.5–2 million c. 2–4 million d. 6–7 million 15. Hearing loss may affect at least a. 25% of adults over age 65. b. 50% of adults over age 65. c. 75% of adults over age 65. d. 90% of adults over age 65.

16. The best source(s) of clinical evidence is/are a. company websites. b. magazine articles. c. peer-reviewed journals. d. clinical experience of seasoned professionals.

17. Audiology experienced a boom in which decade due to WWII veterans who were experiencing noise-induced hearing loss. a. The 1910s b. The 1920s c. The 1940s d. The 1950s 18. The first professional journal related to communication was called a. The Voice. b. Speech Correction. c. Journal of the National Association of Teachers of Speech. d. Speech.

19. Which organization was the precursor to ASHA? a. The National Education Association b. The American Academy of Speech Correction c. American Coalition of Citizens with Disabilities d. The Education for All Handicapped Children Agency 20. Audiology become a profession in a. the 1890s. b. the 1920s. c. the 1940s. d. the 1950s.

21. What are the differences among the concepts of “impairment,” “disability,” and “handicap?”

22. Explain how people with disabilities have been treated throughout history.

23. What is a communication disorder?

24. What is telepractice?

25. What do speech, language, and hearing scientists do?

26. In addition to the entry-level degree, what else do audiologists need in terms of credentials?

27. In addition to the entry-level degree, what else do SLPs need in terms of credentials?

28. What are the assumptions of evidence-based practice?

29. What are some of the key features of the Disability Rights Movement?

30. What are the three key elements of efficacy?

31. What are some factors that affect clinical decision making?

32. Compare and contrast the principles of “efficacy” and “effectiveness.”

33. Name and briefly describe four federal mandates affecting people with disabilities.

(d) Chapter 1 Test Answer Key 1. A (see page 4, section titled “Communication Disorders”) 2. B (see pages 4–5, section titled “Communication Disorders”) 3. C (see page 5, section titled “Communication Disorders”) 4. D (see page 5, section titled “Communication Disorders”) 5. B (see page 5, section titled “Communication Disorders”) 6. C (see page 6, section titled “Audiologists”) 7. B (see page 8, section titled “Speech-Language Pathologists”) 8. B (see page 10, section titled “Speech, Language, and Hearing Scientists”) 9. C (see page 7, section titled “Credentials for Audiologists”) 10. C (see page 9, section titled “Credentials for Speech-Language Pathologists”) 11. A (see page 12, section titled “Service Through the Lifespan”) 12. A (see page 13, section titled “Service Through the Lifespan”) 13. B (see page 16, section titled “Evidence-Based practice”) 14. B (see page 13, section titled “Service Through the Lifespan”) 15. A (see page 13, section titled “Service Through the Lifespan”) 16. C (see page 15, section titled “Evidence-Based Practice”) 17. C (see page 18, section titled “Communication Disorders in Historical Perspective”) 18. A (see page 18, section titled “Communication Disorders in Historical Perspective”) 19. B (see page 18, section titled “Communication Disorders in Historical Perspective”) 20. B (see page 18, section titled “Communication Disorders in Historical Perspective”)

21. Answers may vary but should include some of the following information (see page 3, Introduction): An impairment is a biological or physiological condition that involves the loss of physical, social, or cognitive functioning. This can lead to disability or a restriction in ability to perform a function as a result of the impairment. According to the A DA, a disability is a “physical or mental impairment that substantially limits one or more major life activity.” This may or may not lead to a handicap, which is a social disadvantage that accrues to the individual with an impairment or a disability, often in the form of barriers that can prevent an individual from reaching a goal or a person‟s potential.

22. Answers will vary, but should include some of the following points (see page 17, section titled “Communication Disorders in Historical Perspective”): Children who were malformed or had obvious physical disabilities were sometimes abandoned. Older adults were sometimes abandoned, deprived of food, or killed when they could no longer contribute. Some people with disabilities were considered to have special powers. In the late 1700s to early 1800s, individuals were classified and grouped according to their disorder so that they could be helped. Special residences for individuals with deafness, blindness, mental illness, and intellectual limitations were established, although they were often little more than warehouses providing no services other than what was necessary to keep residents alive.

23. Answers will vary, but should include some of the following points (see page 4, section titled “Communication Disorders”): A communication disorder impairs the ability to both receive and send and also process and comprehend concepts or verbal, nonverbal, and graphic information. A communication disorder may affect hearing, language, and/or speech processes; may range from mild to profound severity; and may be developmental or acquired.

One or a combination of communication disorders may be presented by an individual and may result in a primary disability or may be secondary to other disabilities.

24. Answers will vary, but should include some of the following points (see page 6, section titled “The Professionals and Their Roles”): Provision of speech and language assessment and intervention via the Internet. The COVID pandemic caused a shift to telepractice in many areas of service.

25. Answers will vary, but should include some of the following points (see pages 10–11, section titled “What Speech, Language, and Hearing Scientists Do”): Speech scientists may be involved in basic research exploring anatomy, physiology, and physics of speech-sound production. Investigate the causes, prevention, and treatment of various speech impairments. Development of computer-generated speech. Language scientists may investigate the ways children learn language.

Conduct cross-cultural studies of language and communication. Study how languages are changing. Examine language disabilities and the nature of language disorders in children and adults. Hearing scientists investigate the nature of sound, noise, and hearing. They may help develop equipment for hearing assessment.

Develop techniques for testing infants or those with physical or psychological impairments. Develop and improve assistive listening devices. Concerned with conservation of hearing and limiting environmental noise.

26. Answers may vary but should include the following information (see page 7, section titled “Credentials for Audiologists”): Educational requirements are 3–5 years of professional education beyond the bachelor‟s degree ASHA CCC-A: Requires doctorate, professional experience, national exam. States require audioligists to obtain a state license. The requirements for state licensure tend to be the same or similar to the ASHA standards.

27. Answers may vary, but should include some of the following points (see page 9, section titled “Credentials for Speech-Language Pathologists”): SLPs have a master‟s or doctoral degree. ASHA CCC-SLP: Requires master‟s degree or doctorate, completion of a moitored clinical fellowship year, and successful completion of a national qualifying exam. Ongoing professional development must be demonstrted. Individual states have licensure laws for SLPs. Most states accept a person with an ASHA CCC-SLP as having met state licensure requirements.

28. Answers may vary, but should include the following information (see page 14, section titled “Evidence-Based Practice): Clinical skill grows from experience and current available data. The SLP or audiologist seeks new therapeutic information to improve efficacy.

29. Answers may vary but should include some of the following information (see page 19, section titled “Communication Disorders in Historical Perspective”): In recent years, there has been a positive movement among those with disabilities to organize and to express pride in their identity and self-advocacy. This has been called the Disability Rights Movement and mirrors other civil rights actions. This movement and burgeoning organizations it spawns are often modeled on the community of those with deafness, often called the Deaf Community. Although selfadvocacy is not always possible for those with severe disorders, many groups have coalesced within different disorders, such as individuals with high functioning autism spectrum disorder. These groups, in turn, can offer a voice to their community.

Some communities see the person-first designation to be demeaning and an attempt to hide their disroder, claiming instead older terms, such as identifying as an “autistic person.”

30. Answers should include the following information (see page 15, section titled “Evidence-Based Practice”): It refers to an identified population, not specific individuals. The treatment should be focused and the population should be clearly identified. The research should be conducted under optimal intervention conditions, although actual clinical conditions may be less than idea.

31. Answers may vary but should include some of the following points (see page 16, section titled “Evidence-Based Practice”): Clinician‟s expertise, experience, attitude, and motivation. Client/family values and characteristics. Service delivery variables.

32. Answers should include the following information (see page 15, section titled “Evidence-Based Practice”): While both efficacy and effectiveness refer to the probability of benefit from an intervention method, efficacy is specific to the use of the intervention in ideal conditions whereas effectiveness is specific to the use of the intervention in average conditions.

33. Answers should include the following information (see page 18, section titled “Communication Disorders in Historical Perspective”): 1975: Education for All Handicapped Children Act (E AHCA) (Public Law 94-142): Mandated that a free and appropriate public education (FAPE) must be provided for all handicapped children between ages 5 and 21. Public Law 99-457: Extended age of those served to cover children between the ages of birth and 5 years. 1990: Individuals with Disabilities Act (IDEA): Reauthorization and renaming of the original law; addressed the multicultural nature of the U.S. 2004: Reauthorization of IDEA to established birth to 6 programs as well as new early intervention services.

Article II. Chapter 2 Test Item File

Introduction to Communication Disorders A Lifespan Evidence-Based Perspective

Seventh Edition

Dr. Robert E. Owens, College of St. Rose Dr. Kimberly A. Farinella, Northern Arizona University

Prepared by

Dr. Sarah A. Dachtyl

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Section 2.01

Table of Contents

Chapter 2: Typical and Disordered Communication

1

Learning Objective Quizzes

1

Application Exercises

10

Test Items

13

Test Answer Key

20

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Section 2.02 Chapter 2: Typical and Disordered Communication (a) Chapter 2 Learning Objective Quizzes Learning Objective 2.1: Explain the role of culture and environment in human communication.

[Q1] Janessa is a child attending school in the United States and is an English learner.

Statistically, approximately what percentage of children are English learners?

1. Approximately 10% [correct] 2. Approximately 25% 3. Approximately 30% 4. Approximately 40% [Feedback for Correct Answer 1] Approximately 10% of children are considered English learners.

[Feedback for Answer Choice 2] Approximately 10% of children are considered English learners; 25% is too high.

[Feedback for Answer Choice 3] Approximately 10% of children are considered English learners; 30% is too high.

[Feedback for Answer Choice 4] Approximately 10% of children are considered English learners; 40% is too high.

[Q2] As a speech-language pathologist (SLP), Sarah ensures that she carefully considers the communication environment, which consists of: 1. cultural competence and cultural humility.

2. socioeconomic status, geographical background, and ability.

3. the location, people, and events in which communication occurs. [correct] 4. age, gender, and location.

[Feedback for Answer Choice 1] The communication environment consists of the location, people, and events in which communication occurs. Cultural competence and cultural humility are skills that individuals possess.

[Feedback for Answer Choice 2] 1 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

The communication environment consists of the location, people, and events in which communication occurs. Socioeconomic status, geographical background, and ability are specific to individuals.

[Feedback for Correct Answer 3] The communication environment consists of the location, people, and events in which communication occurs.

[Feedback for Answer Choice 4] The communication environment consists of the location, people, and events in which communication occurs. Age and gender are specific to individuals.

[Q3] Louis studies how such variables as cultural identity, setting, and participants affect communication and its success or failure. His field of study is called: 1. psycholinguistics.

2. speech science.

3. sociology.

4. sociolinguistics. [correct] [Feedback for Answer Choice 1] The study of how variables such as cultural identity, setting, and participants affect communication and its success or failure is called sociolinguistics.

[Feedback for Answer Choice 2] The study of how variables such as cultural identity, setting, and participants affect communication and its success or failure is called sociolinguistics.

[Feedback for Answer Choice 3] The study of how variables such as cultural identity, setting, and participants affect communication and its success or failure is called sociolinguistics.

[Feedback for Correct Answer 4] The study of how variables such as cultural identity, setting, and participants affect communication and its success or failure is called sociolinguistics.

Learning Objective 2.2: Describe the different aspects of human communication.

[Q1] Jason is a child who can produce all of the phonemes in the English language.

Approximately how many phonemes can he produce?

1. 19 2. 26

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3. 37 4. 43 [correct] [Feedback for Answer Choice 1] There are approximately 43 phonemes in the English language. Nineteen is too few.

[Feedback for Answer Choice 2] There are approximately 43 phonemes in the English language. Twenty-six is too few.

There are 26 letters in the English alphabet.

[Feedback for Answer Choice 3] There are approximately 43 phonemes in the English language. Thirty-seven is too few.

[Feedback for Correct Answer 4] There are approximately 43 phonemes in the English language.

[Q2] Samira is a speech-language pathology student, and she is learning to transcribe phonemes in a special alphabet. What is that alphabet called?

1. The National Phoneme Alphabet 2. The Comprehensive Phoneme Alphabet 3. The International Phonetic Alphabet [correct] 4. The Intensive Phoneme Alphabet [Feedback for Answer Choice 1] The alphabet used to transcribe phonemes is called the International Phonetic Alphabet (IPA).

[Feedback for Answer Choice 2] The alphabet used to transcribe phonemes is called the International Phonetic Alphabet (IPA).

[Feedback for Correct Answer 3] The alphabet used to transcribe phonemes is called the International Phonetic Alphabet (IPA).

[Feedback for Answer Choice 4] The alphabet used to transcribe phonemes is called the International Phonetic Alphabet (IPA).

[Q3] When writing evaluation reports, Carolee always make sure to comment on the rate and rhythm of her clients‟ speech. This is referred to as:

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1. prosody. [correct] 2. melody.

3. harmonics.

4. frequency.

[Feedback for Correct Answer 1] The rate and rhythm of speech is called prosody.

[Feedback for Answer Choice 2] The rate and rhythm of speech is called prosody. Melody is a musical term.

[Feedback for Answer Choice 3] The rate and rhythm of speech is called prosody. Harmonics are multiples of the fundamental frequency.

[Feedback for Answer Choice 4] The rate and rhythm of speech is called prosody. Frequency is the number of vibrations per unit of time.

Learning Objective 2.3: Demonstrate how communication disorders may be classified, including the names and frequency of occurrence of different types of communication disorders.

[Q1] Raina‟s speech reflects the region where she was raised. This is referred to as a/an: 1. disorder.

2. congenital difference.

3. acquired impairment.

4. dialect. [correct] [Feedback for Answer Choice 1] Speech that reflects the region in which an individual was raised is a dialect. Dialects are not disorders.

[Feedback for Answer Choice 2] Speech that reflects the region in which an individual was raised is a dialect. Dialects are not referred to as congenital.

[Feedback for Answer Choice 3] Speech that reflects the region in which an individual was raised is a dialect. Dialects are not impairments.

[Feedback for Correct Answer 4]

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Speech that reflects the region in which an individual was raised is a dialect.

[Q2] While in graduate school, Brenda was most fascinated with the cognitive and theoretical concepts of the nature, production, and rules for producing and combining speech sounds in language. This area of study is called: 1. semantics.

2. phonology. [correct] 3. morphology.

4. syntax.

[Feedback for Answer Choice 1] Phonology is the cognitive and theoretical concepts of the nature, production, and rules for producing and combining speech sounds in language. Semantics refers to the meaning of language.

[Feedback for Correct Answer 2] Phonology is the cognitive and theoretical concepts of the nature, production, and rules for producing and combining speech sounds in language.

[Feedback for Answer Choice 3] Phonology is the cognitive and theoretical concepts of the nature, production, and rules for producing and combining speech sounds in language. Morphology involves the structure of words.

[Feedback for Answer Choice 4] Phonology is the cognitive and theoretical concepts of the nature, production, and rules for producing and combining speech sounds in language. Syntax is how words are arranged in a sentence and the ways in which one word may affect another.

[Q3] Julia‟s family pursues the most effective communication intervention for their daughter, who is deaf. Which of the following will they choose?

1. Speech only 2. Auditory training 3. Total communication [correct] 4. Alternative and augmentative communication [Feedback for Answer Choice 1] Total communication is considered the most effective intervention for deafness. Speech only is not a specific treatment.

[Feedback for Answer Choice 2] 5 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Total communication is considered the most effective intervention for deafness. Auditory training may be helpful but is not the most effective intervention.

[Feedback for Correct Answer 3] Total communication is considered the most effective intervention for deafness.

[Feedback for Answer Choice 4] Total communication is considered the most effective intervention for deafness.

Alternative and augmentative communication is not an effective intervention for deafness.

[Q4] Mr. Vasquez experiences pain associated with swallowing. He most likely has: 1. dysphagia. [correct] 2. dysphonia.

3. dysthymia.

4. dysfluency.

[Feedback for Correct Answer 1] Difficulty swallowing is called dysphagia. Swallowing may be associated with pain, or swallowing may be impossible.

[Feedback for Answer Choice 2] Difficulty swallowing is called dysphagia. Dysphonia is a term related to voice, or phonation.

[Feedback for Answer Choice 3] Difficulty swallowing is called dysphagia. Dysthymia is a term related to mood.

[Feedback for Answer Choice 4] Difficulty swallowing is called dysphagia. Dysfluency is a term related to stuttering.

[Q5] Jenna is a 4-year-old girl who has been diagnosed with autism spectrum disorder (A S D). She is not in the majority because: 1. ASD is two times more prevalent in males than in females.

2. ASD is three times more prevalent in males than in females.

3. ASD is four times more prevalent in males than in females. [correct] 4. ASD is five times more prevalent in males than in females.

[Feedback for Correct Answer 1]

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ASD is four times more prevalent in males than in females. The discrepancy in this answer choice is not large enough.

[Feedback for Answer Choice 2] ASD is four times more prevalent in males than in females. The discrepancy in this answer choice is not large enough.

[Feedback for Answer Choice 3] ASD is four times more prevalent in males than in females.

[Feedback for Answer Choice 4] ASD is four times more prevalent in males than in females. The discrepancy in this answer choice is too large.

Learning Objective 2.4: Describe in general the assessment and intervention process.

[Q1] Kristi is a speech-language pathologist in the public schools. When she receives referrals, she often conducts screenings in order to: 1. diagnose the communication disorder.

2. determine whether a problem exists. [correct] 3. develop a prognosis.

4. satisfy the requirements of the Individuals with Disabilities Education Act (I DEA).

[Feedback for Answer Choice 1] The purpose of screening is to determine whether a problem exists, not to diagnose a communication disorder.

[Feedback for Correct Answer 2] The purpose of screening is to determine whether a problem exists.

[Feedback for Answer Choice 3] The purpose of screening is to determine whether a problem exists, not to develop a prognosis.

[Feedback for Answer Choice 4] The purpose of screening is to determine whether a problem exists, not to satisfy the requirements of the IDEA. [Q2] A test-teach-retest procedure was used in an evaluation for Joaquin, a child with a suspected communication impairment. This method falls under the category of: 1. dynamic assessment. [correct] 2. criterion-referenced assessment.

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3. standardized assessment.

4. norm-referenced tests.

[Feedback for Correct Answer 1] Dynamic assessment includes probing to explore a client‟s ability to modify behavior, as in a test-teach-retest paradigm.

[Feedback for Answer Choice 2] Dynamic assessment includes probing to explore a client‟s ability to modify behavior, as in a test-teach-retest paradigm. Criterion-referenced assessments evaluate a client‟s strengths and weaknesses with regard to particular skills and do not make comparisons to other children.

[Feedback for Answer Choice 3] Dynamic assessment includes probing to explore a client‟s ability to modify behavior, as in a test-teach-retest paradigm. Standardized assessments utilize normative data.

[Feedback for Answer Choice 4] Dynamic assessment includes probing to explore a client‟s ability to modify behavior, as in a test-teach-retest paradigm. Norm-referenced tests yield scores that are used to compare a client with a sample of similar individuals.

[Q3] Kendra, a medical SLP, always ensures that she collects baseline data, which is essential for: 1. insurance reimbursement.

2. determining the likelihood that generalization will occur.

3. determining behavior modification candidacy.

4. determining a client‟s progress and the success of treatment. [correct] [Feedback for Answer Choice 1] Baselines are essential in determining a client‟s progress and the success of a treatment program. There are multiple necessary elements for insurance reimbursement for services.

[Feedback for Answer Choice 2] Baselines are essential in determining a client‟s progress and the success of a treatment program. There is no specific relationship between baseline data and likelihood of generalization.

[Feedback for Answer Choice 3] Baselines are essential in determining a client‟s progress and the success of a treatment program, not for determining candidacy for use of behavior modification techniques.

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[Feedback for Correct Answer 4] Baselines are essential in determining a client‟s progress and the success of a treatment program.

[Q4] Mrs. Zheng is struggling to generalize the skills she learned in therapy and in processing her feelings related to the stroke she experienced 6 months ago. In order to support both of these needs, her therapist appropriately recommended she: 1. be discharged from therapy.

2. participate in therapy alone and without family involvement.

3. consider joining a support group. [correct] 4. participate in therapy that is solely focused on behavior modification.

[Feedback for Answer Choice 1] Support groups can provide an avenue to practice what has been learned in therapy, share feelings about the disability, and maintain communication skills once formal treatment has been terminated. Discharge from therapy at this time would not address her needs.

[Feedback for Answer Choice 2] Support groups can provide an avenue to practice what has been learned in therapy, share feelings about the disability, and maintain communication skills once formal treatment has been terminated. Family involvement is an important element of many treatment plans.

[Feedback for Correct Answer 3] Support groups can provide an avenue to practice what has been learned in therapy, share feelings about the disability, and maintain communication skills once formal treatment has been terminated.

[Feedback for Answer Choice 4] Support groups can provide an avenue to practice what has been learned in therapy, share feelings about the disability, and maintain communication skills once formal treatment has been terminated. A sole focus on behavior modification would not address all her needs.

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(b) Chapter 2 Application Exercises Application Exercise 2.1: Describe pragmatics, or language use.

Learning Objective 2.2: Describe the different aspects of human communication.

Reference: Pearson e-Text Video Example 2.2 [Q1] Use Pearson e-Text Video Example 2.2 to answer the following question: According to this video, what is pragmatics?

[Q1 Model Response] Pragmatics answers the question “Why,” as in why people use language the way they do. It is the study of the choices we make when we use language, the reasons for those choices, and the effects of those choices.

[Q2] Use Pearson e-Text Video Example 2.2 to answer the following question: According to this video, what are some potential reasons for language use choices that we make?

[Q2 Model Response] Our choices may have something to do with context, meaning, emphasis, vocabulary, or relationship to the communication partner or person we are referencing.

[Q3] Use Pearson e-Text Video Example 2.2 to answer the following question: According to this video, what can the choices we make in addressing someone reveal?

[Q3 Model Response] It can reveal our history with a person. Pragmatics can answer the question of why we used a nickname rather than formally addressing the individual. Every language choice has a reason.

Application Exercise 2.2: Describe stuttering, a speech disorder.

Learning Objective 2.3: Demonstrate how communication disorders may be classified, including the names and frequency of occurrence of different types of communication disorders.

Reference: Pearson e-Text Video Example 2.2 [Q1] Use Pearson e-Text Video Example 2.4 to answer the following question: 10 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

According to this video, what is stuttering?

[Q1 Model Response] Stuttering is the interruption of the forward flow of speech caused by blocks, insertions, and repetitions.

[Q2] Use Pearson e-Text Video Example 2.4 to answer the following question: According to this video, what are secondary behaviors?

[Q2 Model Response] They are behaviors that accompany stuttering, such as head jerks, head nods, and eye blinks.

[Q3] Use Pearson e-Text Video Example 2.4 to answer the following question: According to this video, how does stuttering impact an individual‟s life?

[Q3 Model Response] Speech interruptions affect the flow of speech, behavior, emotions, and ability to communicate within the individual‟s environment.

Application Exercise 2.3: Describe standardized assessments.

Learning Objective 2.4: Describe in general the assessment and intervention process.

Reference: Pearson e-Text Video Example 2.5 [Q1] Use Pearson e-Text Video Example 2.5 to answer the following question: According to this video, what are two ways that standardized tests measure performance?

[Q1 Model Response] Some standardized tests measure scores in relation to other test takers, and others measure performance on how well test takers meet predetermined criteria.

[Q2] Use Pearson e-Text Video Example 2.5 to answer the following question: According to this video, what is a percentile? Give an example.

[Q2 Model Response]

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If an individual is in the 70th percentile, 70% of test takers scored below them. If they score in the 30th percentile, 70% of test takers score above them.

[Q3] Use Pearson e-Text Video Example 2.5 to answer the following question: According to this video, what are two ways that standardized tests could measure the wrong things?

[Q3 Model Response] Standardized tests could measure the wrong things if they are given the wrong job or aren‟t designed properly. This reduces reliability and validity, which are important features of standardized tests.

[Q4] Use Pearson e-Text Video Example 2.5 to answer the following question: According to this video, what are some barriers students might experience when taking standardized tests?

[Q4 Model Response] Barriers could include test anxiety, reading challenges, and unfamiliar cultural references. Each of these could cause a student to perform more poorly than they might otherwise.

[Q5] Use Pearson e-Text Video Example 2.5 to answer the following question: According to this video, what is the broken thermometer analogy for illustrating the concepts of reliability and validity?

[Q5 Model Response] An unreliable thermometer gives you a different reading each time you take your temperature, whereas a reliable but invalid thermometer is consistently 10 degrees too hot.

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(c) Chapter 2 Test Items 1. Which of the following is the most accurate definition of the term “communication?” a. It is an exchange between senders and receivers. b. It is another word for speech. c. It is the process of self-expression. d. It is the exclusively human quality to talk to other humans.

2.

is how cultural identity, setting, and participants influence communication. a. Metalinguistics b. Sociolinguistics c. Psycholingustics d. Multiculturalism

3. Grammar refers to a. the rules of a language. b. the recognition by a native speaker of whether something is said “right” or “wrong.” c. only the sound system of a language. d. the process of producing the acoustic representation of language.

4. Form consists of a. phonology, morphology, and syntax. b. semantics, syntax, and pragmatics. c. phonology, phonotactic rules, and morphology. d. free morphemes, bound morphemes, and syntax.

5.

is how words are arranged in a sentence and the ways in which one word may affect another. a. Syntax b. Semantics c. Morphology d. Pragmatics

6. Content consists of a. syntax and semantics. b. pragmatics. c. semantics.

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d. morphology and phonology.

7. Use consists of a. syntax and semantics. b. pragmatics. c. semantics. d. morphology and phonology.

8.

is how and why we use language; it varies with culture. a. Syntax b. Communication c. Speech d. Pragmatics

9. Voice can reveal things about the speaker and the message. is a listener‟s perception of how high or low a sound is, is the basic tone that an individual uses most of the time, and is the pitch movement within an utterance. a. Habitual pitch, pitch, intonation b. Intonation, pitch, habitual pitch c. Pitch, intonation, habitual pitch d. Pitch, habitual pitch, intonation 10. About two-third of human meaning exchange is a. verbal. b. vocal. c. nonverbal. d. nonvocal.

11.

refer to how you look, your clothes, your possessions, and your general appearance. a. Kinesics b. Proxemics c. Artifacts d. Tactiles

12.

refer to the way we move our body, or body language. a. Kinesics b. Proxemics c. Artifacts 14 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

d. Tactiles 13.

refer to the physical distance between people as it affects communication. a. Kinesics b. Proxemics c. Tactiles d. Chronemics

14.

refer to touching behaviors. a. Kinesics b. Proxemics c. Tactiles d. Chronemics

15.

is the cause or origin of a problem, and may be used to classify a communication problem. a. Dialect b. Etiology c. Congenital disorder d. Transmission

16.

disorders are present at birth, whereas disorders are the result of illness, accident, or environmental circumstances later in life. a. Etiological, dialectal b. Genetic, accidental c. Congenital, acquired d. Primary, secondary

17.

is a speech disorder caused by paralysis, weakness, or poor coordination of the speech musculature. a. Dysarthria b. Apraxia c. Dysphagia d. Stuttering

18.

is a speech disorder that is due to neuromotor programming difficulties. a. Dysarthria

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b. Dysphagia c. Aphasia d. Apraxia 19. In disorders of affected.

, the smooth, uninterrupted flow of speech is

a. Articulation b. Voice c. Language d. Fluency 20.

is the term for excessive yelling, screaming, or loud singing. It can result in hoarseness or another voice disorder. a. Vocal hygiene b. Vocal abuse c. Vocal strain d. Vocal exertion

21. Difficulty swallowing is called a. apraxia. b. dysarthria. c. dysphagia. d. aphasia.

22. What are the ways in which hearing loss can be categorized? a. Severity, laterality, and type b. Minimal or complete c. Pre-existing or acquired d. Location, degree, and impact 23. A hearing loss that is caused by damage to the outer or middle ear. a. Conductive b. Sensorineural c. Mixed d. Central 24. A hearing loss that is due to problems with the inner ear and/or auditory nerve. a. Conductive b. Sensorineural 16 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

c. Mixed d. Central 25.

is the actual production of speech sounds. a. Dictation b. Morphology c. Phonology d. Articulation

26. What percentage of the U.S. population has a communication disorder? a. 1% b. 4% c. 9% d. 17% 27.

distinguish(es) an individual‟s difficulties from the broad range of possible problems. a. Etiological factors b. Genetic markers c. Predisposing causes d. Diagnosis

28.

refers to working with a client for a time to obtain a clearer picture of strengths and weaknesses. a. Response to intervention b. Constraint-induced therapy c. Diagnostic therapy d. The cycles approach

29. A prognosis is a. an informed prediction of an outcome. b. a trigger for a disorder. c. a factor that continues to add to a problem. d. the background information gathered prior to testing.

30.

tests yield scores that are used to compare a client with a sample of similar individuals. a. Dynamic assessment b. Criterion-referenced

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c. Norm-referenced d. Authentic assessments tests evaluate a client‟s strengths and weaknesses with

31. regard to particular skills. a. Dynamic assessment b. Criterion-referenced c. Norm-referenced

d. Authentic assessments 32. Baseline data is a. a measurement of the client‟s accuracy before beginning intervention. b. the data from a normative sample. c. test scores from norm-referenced tests. d. unnecessary for determining progress.

33. In incidental teaching, a. the SLP provides a stimulus and reinforces the response if it is correct. b. the parent is responsible for providing therapeutic intervention after instruction. c. the SLP follows the client‟s lead and teaches along the way. d. the child is encouraged to learn language skills from other children in the environment.

34. Describe auditory processing disorders. Include symptoms and etiology.

35. Compare and contrast cultural competence and cultural humility.

36. What does it mean that languages are generative and dynamic?

37. Name the three primary components of language.

38. Briefly explain how phonology and phontactic rules differ.

39. Briefly define morphology, morphemes, free morphemes, and bound morphemes.

40. Two aspects of speech include articulation and fluency. Briefly describe both.

41. Briefly (in 6–10 sentences) explain communication through the lifespan. Be sure to touch on how infants learn language, cultural considerations, and how we end up being competent communicators.

42. Briefly describe disorders of form and potential etiologies.

43. Briefly describe disorders of content and potential etiologies.

44. Briefly describe disorders of use.

45. Provide definitions and/or examples of the following: fillers, hesitations, repetitions, and prolongations.

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46. What is stuttering?

47. What are some habits that can affect normal voice production?

48. What is deafness?

49. Compare and contrast incidence and prevalence.

50. What are two possible causes of disorders of form?

51. Briefly explain why the term “typical” might be preferable to “normal.”

52. Name four factors that influence intervention.

53. What are five objectives of intervention?

54. What is the A, B, C, and D of behavioral objectives?

55. What are the functions of support groups for communication disorders?

56. If therapy has been effective, the client is successful in what four areas?

57. Briefly describe the follow-up and maintenance process.

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(d) Chapter 2 Test Answer Key 1. A (see page 21, Introduction) 2. B (see page 22, section titled “The Role of Culture and the Environment”) 3. A (see page 25, section titled “Language”) 4. A (see page 25, section titled “Form”) 5. A (see page 26, section titled “Form”) 6. C (see page 26, section titled “Content”) 7. B (see page 26, section titled “Use”) 8. D (see page 26, section titled “Use”) 9. D (see page 29, section titled “Voice”) 10. C (see page 29, section titled “Nonverbal Communication”) 11. C (see page 29, section titled “Artifacts”) 12. A (see page 29, section titled “Kinesics”) 13. B (see page 30, section titled “Proxemics”) 14. C (see page 30, section titled “Kinesics”) 15. B (see page 34, section titled “Communication and Swallowing Disorders”) 16. C (see page 34, section titled “Communication and Swallowing Disorders”) 17. A (see page 36, section titled “Disorders of Articulation”) 18. D (see page 36, section titled “Disorders of Articulation”) 19. D (see page 36, section titled “Disorders of Fluency”) 20. B (see page 37, section titled “Disorders of Voice”) 21. C (see page 38, section titled “Swallowing Disorders”) 22. A (see page 38, section titled “Hard of Hearing”) 23. A (see page 38, section titled “Hard of Hearing”) 24. B (see page 38, section titled “Hard of Hearing”) 25. D (see page 36, section titled “Disorders of Articulation”) 26. D (see page 40, section titled “Estimates of Prevalence”) 27. D (see page 43, section titled “Defining the Problem”) 28. C (see page 44, section titled “Assessment Goals”) 29. A (see page 45, section titled “Assessment Goals”) 30. C (see page 46, section titled “Assessment Procedures”) 31. B (see page 46, section titled “Assessment Procedures”) 20 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

32. A (see page 48, section titled “Baseline Data”) 33. C (see page 49, section titled “Incidental Teaching”) 34. Answers may vary, but should include the following points (see page 38, section titled “Auditory Processing Disorders”): Individuals with APD may have normal hearing but difficulty understanding speech.

Difficulty keeping up with conversation, understanding speech in less-than-optimal listening conditions, discriminating and identifying speech sounds, and integrating what they hear with nonverbal aspects of communication. Etiology is often unknown, but can be due to tumor, disease, or brain injury. May coexist with other disorders.

35. Answers may vary, but should include the following points (see page 23, section titled “Cultural Identity”): Cultural competence is understanding, appreciating, and responding appropriately to a full range of diversity dimensions that you and clients and families bring to an interaction. Cultural humility is recognition that to be truly effective we must recognize that learning and self-reflection are lifelong, that power imbalances exist and must be addressed, and that institutions must be accountable.

36. Answers may vary, but should include the following points (see page 25, section titled “Language”): Generative means that each utterance is freshly created.

Dynamic means that languages change over time.

37. Answers should include the following information (see page 25, section titled “Language”): Form, content, and use 38. Answers may vary, but should include the following points (see page 25, section titled “Form”): Phonology is the sound system of a language, whereas phonotactic rules specify how sounds may be arranged in words.

39. Answers may vary, but should include the following points (see page 26, section titled “Form”): Morphology involves the structure of words. Morphemes are the smallest grammatical units of a language. Free morphemes may stand alone as words.

Bound morphemes change the meaning of the original words and can only be attached to free morphemes.

40. Answers may vary, but should include the following points (see pages 27–28, sections titled “Articulation” and “Fluency”): Articulation is the actual production of speech sounds. Fluency is the smooth, forward flow of speech.

41. Answers may vary, but should include the following points (see pages 30 and 33, section titled “Communication Through the Lifespan”): 21 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Infants must first learn the rudiments of communication and begin to master speech.

The early establishment of communication between children and caregivers fosters the development of speech and language, which influence the quality of communication. This is fostered by physical, cognitive, and social development. The key to becoming a communicator is being treated as one. The process of learning speech and language is a social one that occurs through interactions of children and the people in their environment. In different cultures, the type of child-caregiver interaction, the model of language presented to the child, and the expectations for the child differ, but each is sufficient for the learning of the language of the culture.

Every person‟s speech and language continues to change until the end of life. A competent communicator continues to adapt to changes in the language and in the communication process.

42. Answers may vary, but should include the following points (see page 35, section titled “Disorders of Form”): Errors in sound use constitute a disorder of phonology. Incorrect use of past tense or plural markers is an example of a disorder of morphology. Syntactical errors include incorrect word order and run-on sentences. May be due to sensory limitations, perceptual difficulties, limited exposure to correct models, or neurological disorders.

The cause may also not be apparent.

43. Answers may vary, but should include the following points (see page 35, section titled “Disorders of Content”): Limited vocabulary, misuse of words, or word-finding problems. Difficulty understanding and using abstract language. A persistent pattern of avoiding naming objects and referring isntead to “the thing” is another indication of a disorder of content. May be due to limited experience, concrete learning style, stroke, head trauma, or certain illnesses with cognitive impairment.

44. Answers may vary, but should include the following points (see pages 35–36, section titled “Disorders of Use”): Pragmatic language problems may be related to limited or unacceptable conversational, social, and narrative skills; deficits in spoken vocabulary; and/or immature or disordered phonology, morphology, and syntax. Might include difficulty staying on topic, providing inappropriate or incongruent responses to questions, or continually interrupting the conversational partner.

45. Answers may vary, but should include the following points (see pages 36–37, section titled “Disorders of Fluency”): Fillers: “er,” “um,” “ya know.” Hesitations: unexpected pauses. Repetitions: Sounds, syllables, or words are repeated, as in “g-g-g-go.” Prolongations: Excessively long duration, as in “wwwwwwell.”

46. Answers may vary, but should include the following points (see page 37, section titled “Disorders of Fluency”): When these speech behaviors (fillers, hesitations, repetitions, prolongations) exceed or are qualitatively different from the norm or are accompanied by excessive tension, 22 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

struggle, and fear.

47. Answers may vary, but should include the following points (see page 37, section titled “Disorders of Voice”): Physical tension, coughing, throat clearing, smoking, and drinking alcohol can disrupt normal voice production.

48. Answers may vary, but should include the following points (see page 38, section titled “Deafness”): When a person‟s ability to perceive sound is limited to such an extent that the auditory channel is not the primary sensory input for communication. It may be congenital or acquired.

49. Answers may vary, but should include the following points (see page 40, section titled “Estimates of Prevalence”): Incidence refers to the number of new cases of a disease or disorder in a particular time period. Prevalence is the number or percentage of people within a specified population who have a particular disorder or condition at a given point in time.

50. Answers may vary, but should include the following points (see page 35, section titled “Disorders of Form”): May be due to sensory limitations, perceptual difficulties, limited expsure to correct models, or neurological disorders. The cause may also not be apparent.

51. Answers may vary, but should include the following points (see pages 39–40, section titled “What is „Normal‟?”): Variability is the norm. Typical is a better term than “normal” when we mean “like most others of the same age and group.”

52. Answers may vary, but should include the following points (see page 47, section titled “Intervention with Communication and Swallowing Disorders”): Nature and severity of the disorder, the age and status of the client, environmental considerations, and personal/cultural characteristics of the client and clinician.

53. Answers may vary, but should include the following points (see page 48, section titled “Objectives of Intervention”): The client should show improvement and this should generalize. What has been learned should be largely automatic. The client must be able to self-monitor. The client should make optimum progress in the minimum amount of time. Intervention should be sensitive to the personal and cultural characteristics of the client.

54. Answers may vary, but should include the following points (see page 49, section titled “Behavioral Objectives”): Actor: Who is expected to do the behavior? Behavior: What is the observable and measurable behavior? Condition: What is the context or condition of the behavior?

Degree: What is the targeted degree of success?

55. Answers may vary, but should include the following points (see page 50, section 23 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

titled “Family and Environmental Involvement”): They can provide an avenue to practice what has been learned in therapy, share feelings about the disability, and maintain communication skills once formal treatment has been terminated.

56. Answers may vary, but should include the following points (see page 50, section titled “Measuring Effectiveness”): Generalizing the learned skills, self-monitoring, self-correcting, and experiencing automaticity.

57. Answers may vary, but should include the following points (see page 50, section titled “Follow-up and Maintenance”): Upon dismissal, the client or family should be encouraged to return if there is a need. A regular follow-up schedule can be established. Booster treatment may be provided if needed.

Article III. Chapter 3 Test Item File

Introduction to Communication Disorders A Lifespan Evidence-Based Perspective

Seventh Edition

Dr. Robert E. Owens, College of St. Rose 24 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Dr. Kimberly A. Farinella, Northern Arizona University

Prepared by

Dr. Sarah A. Dachtyl

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Section 3.01

Table of Contents

Chapter 3: Overview of the Anatomy and Physiology of Swallowing and Speech Production 1 Learning Objective Quizzes

1

Application Exercises

9

Test Items

12

Test Answer Key

18

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Section 3.02 Chapter 3: Overview of the Anatomy and Physiology of Swallowing and Speech Production (a) Chapter 3 Learning Objective Quizzes Learning Objective 3.1: List and describe the principal structures and muscles of the respiratory system and differentiate resting tidal breathing from speech breathing.

[Q1] For feeding, most healthy individuals: 1. hold their breath when they swallow. [correct] 2. breathe out when they swallow.

3. inhale slightly when they swallow.

4. forcefully exhale when they swallow.

[Feedback for Correct Answer 1] For feeding, most healthy individuals hold their breath when they swallow.

[Feedback for Answer Choice 2] For feeding, most healthy individuals hold their breath when they swallow. They do not tend to breathe out.

[Feedback for Answer Choice 3] For feeding, most healthy individuals hold their breath when they swallow. They do not tend to inhale.

[Feedback for Answer Choice 4] For feeding, most healthy individuals hold their breath when they swallow. They do not tend to forcefully exhale.

[Q2] These muscles elevate the rib cage when they contract, increasing the size of the thoracic cavity.

1. Internal obliques 2. Internal intercostals 3. External obliques 4. External intercostals [correct] [Feedback for Answer Choice 1] The external intercostals elevate the rib cage when they contract, increasing the size of the thoracic cavity. The internal obliques form a portion of the abdominal wall.

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Contraction pulls the lower ribs and sternum downward and forces the abdominal wall inward.

[Feedback for Answer Choice 2] The external intercostals (rather than the internal intercostals) elevate the rib cage when they contract, increasing the size of the thoracic cavity.

[Feedback for Answer Choice 3] The external intercostals elevate the rib cage when they contract, increasing the size of the thoracic cavity. The external obliques form part of the abdominal wall. Contraction pulls the lower ribs and sternum downward and forces the abdominal wall inward.

[Feedback for Correct Answer 4] The external intercostals elevate the rib cage when they contract, increasing the size of the thoracic cavity. They consist of 11 paired muscles located in the spaces between the outer portions of the ribs.

[Q3] Motor commands from the breathing purposes.

activate the diaphragm for

1. pulmonary apparatus 2. respiratory brainstem centers [correct] 3. abdominal aponeurosis 4. rectus abdominis [Feedback for Answer Choice 1] Motor commands from the respiratory brainstem centers activate the diaphragm. The pulmonary apparatus consists of the pulmonary airways and lungs.

[Feedback for Correct Answer 2] Motor commands from the respiratory brainstem centers activate the diaphragm.

[Feedback for Answer Choice 3] Motor commands from the respiratory brainstem centers activate the diaphragm. The abdominal aponeurosis and the abdominal muscles enclose and support the abdominal content.

[Feedback for Answer Choice 4] Motor commands from the respiratory brainstem centers activate the diaphragm. The rectus abdominis is a muscle within the abdominal wall.

Learning Objective 3.2: List and describe the principal structures, muscles, and functions of the laryngeal system.

[Q1] 2 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

This leaf-shaped cartilage assists in preventing food from entering the larynx and lower airways during swallowing.

1. Arytenoid cartilage 2. Epiglottis [correct] 3. Thyroid cartilage 4. Hyoid cartilage [Feedback for Answer Choice 1] The epiglottis is a large leaf-shaped cartilage attached at its lower end to the thyroid cartilage and at its midportion to the body of the hyoid bone. The epiglottis assists in preventing food from entering the larynx and lower airways during swallowing. The arytenoid cartilages are pyramid-shaped paired cartilages.

[Feedback for Correct Answer 2] The epiglottis is a large leaf-shaped cartilage attached at its lower end to the thyroid cartilage and at its midportion to the body of the hyoid bone. The epiglottis assists in preventing food from entering the larynx and lower airways during swallowing.

[Feedback for Answer Choice 3] The epiglottis is a large leaf-shaped cartilage attached at its lower end to the thyroid cartilage and at its midportion to the body of the hyoid bone. The epiglottis assists in preventing food from entering the larynx and lower airways during swallowing. The thyroid cartilage forms the front and sides of the laryngeal skeleton and protects the inner components of the larynx. The upper part has a V-shaped depression called the thyroid notch.

[Feedback for Answer Choice 4] The epiglottis is a large leaf-shaped cartilage attached at its lower end to the thyroid cartilage and at its midportion to the body of the hyoid bone. The epiglottis assists in preventing food from entering the larynx and lower airways during swallowing. The hyoid is a bone rather than a cartilage. The hyoid bone is a U-shaped, free-floating structure that serves as the point of attachment for laryngeal and tongue musculature.

[Q2] The thyroarytenoid, cricothyroid, posterior cricoarytenoid, lateral cricoarytenoid, and arytenoid muscles are classified as: 1. extrinsic laryngeal muscles.

2. constrictor muscles.

3. intrinsic laryngeal muscles. [correct] 4. transverse laryngeal muscles.

[Feedback for Answer Choice 1]

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These muscles are classified as intrinsic laryngeal muscles and are critical for phonation and for modifying the pitch and loudness of the voice. Extrinsic laryngeal muscles include the sternothyroid, thyroid, and inferior constrictor muscles.

[Feedback for Answer Choice 2] These muscles are classified as intrinsic laryngeal muscles and are critical for phonation and for modifying the pitch and loudness of the voice. There is not a category of laryngeal muscles labeled constrictor muscles.

[Feedback for Correct Answer 3] These muscles are classified as intrinsic laryngeal muscles and are critical for phonation and for modifying the pitch and loudness of the voice.

[Feedback for Answer Choice 4] These muscles are classified as intrinsic laryngeal muscles and are critical for phonation and for modifying the pitch and loudness of the voice. There is a transverse arytenoid muscle that brings the pack portion of the vocal folds together.

[Q3] When does the vocal ligament appear?

1. Between 3 and 6 months of age 2. Between 9 and 12 months of age 3. Between 1 and 4 years of age [correct] 4. Between 4 and 6 years of age [Feedback for Answer Choice 1] In a newborn, the vocal fold‟s makeup is homogenous, with undifferentiated lamina propria. The vocal ligament appears sometime between 1 and 4 years of age. Between 3 and 6 months is too early.

[Feedback for Answer Choice 2] In a newborn, the vocal fold‟s makeup is homogenous, with undifferentiated lamina propria. The vocal ligament appears sometime between 1 and 4 years of age. Between 9 and 12 months is too early.

[Feedback for Correct Answer 3] In a newborn, the vocal fold‟s makeup is homogenous, with undifferentiated lamina propria. The vocal ligament appears sometime between 1 and 4 years of age.

[Feedback for Answer Choice 4] In a newborn, the vocal fold‟s makeup is homogenous, with undifferentiated lamina propria. The vocal ligament appears sometime between 1 and 4 years of age. Between 4 and 6 years is too late.

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Learning Objective 3.3: Briefly describe the structures and functions of the upper airway.

[Q1] The

form(s) the back of the oral cavity.

1. mandible 2. tongue 3. faucial pillars [correct] 4. velum [Feedback for Answer Choice 1] The faucial pillars form the back of the oral cavity. The mandible is an unpaired facial bone that articulates with the temporal bone via the temporomandibular joint.

[Feedback for Answer Choice 2] The faucial pillars form the back of the oral cavity. The tongue is the principal structure within the oral cavity and is important for swallowing and speech production.

[Feedback for Correct Answer 3] The faucial pillars form the back of the oral cavity.

[Feedback for Answer Choice 4] The faucial pillars form the back of the oral cavity. The velum is located in the pharynx.

[Q2] Contraction of which muscle(s) pulls the lateral margins of the tongue up?

1. Vertical muscles 2. Superior longitudinal muscle [correct] 3. Transverse muscles 4. Inferior longitudinal muscle [Feedback for Answer Choice 1] The superior longitudinal muscle pulls the lateral margins of the tongue up. The tongue can be narrowed and elongated or broadened and flattened by contraction of the transverse and vertical muscles, respectively.

[Feedback for Correct Answer 2] The superior longitudinal muscle pulls the lateral margins of the tongue up.

[Feedback for Answer Choice 3]

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The superior longitudinal muscle pulls the lateral margins of the tongue up. The tongue can be narrowed and elongated or broadened and flattened by contraction of the transverse and vertical muscles, respectively.

[Feedback for Answer Choice 4] The superior longitudinal muscle pulls the lateral margins of the tongue up. Contraction of the inferior longitudinal muscle shortens the tongue and pulls the tongue tip downward.

[Q3] Contraction of which muscle pulls the velum upward and backward?

1. Uvulas muscle 2. Palatoglossus muscle 3. Palatopharyngeal muscle 4. Palatal levator muscle [correct] [Feedback for Answer Choice 1] The palatal levator muscle forms much of the bulk of the velum and pulls the velum upward and backward. The uvulas muscle shortens and lifts the velum.

[Feedback for Answer Choice 2] The palatal levator muscle forms much of the bulk of the velum and pulls the velum upward and backward. The palatoglossus muscle pulls the velum down and forward.

[Feedback for Answer Choice 3] The palatal levator muscle forms much of the bulk of the velum and pulls the velum upward and backward. The palatopharyngeal muscle pulls the velum down and backward.

[Feedback for Correct Answer 4] The palatal levator muscle forms much of the bulk of the velum and pulls the velum upward and backward.

Learning Objective 3.4: Explain the speech production process.

[Q1] is initiated by approximating or adducting the vocal folds and closing the glottis.

1. Pharyngeal constriction 2. Phonation [correct] 3. Palatal elevation 4. Epiglottal inversion

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[Feedback for Answer Choice 1] Phonation is initiated by approximating or adducting the vocal folds and closing the glottis. Pharyngeal constriction is a narrowing of the pharynx and is not the initiation of phonation.

[Feedback for Correct Answer 2] Phonation is initiated by approximating or adducting the vocal folds and closing the glottis.

[Feedback for Answer Choice 3] Phonation is initiated by approximating or adducting the vocal folds and closing the glottis. Palatal elevation is not the initiation of phonation.

[Feedback for Answer Choice 4] Phonation is initiated by approximating or adducting the vocal folds and closing the glottis. Epiglottal inversion is unrelated to the initiation of phonation.

[Q2] What properties of the vocal folds result in them colliding, closing off the airway?

1. Elastic properties [correct] 2. Muscular properties 3. Ossification properties 4. Cartilaginous properties [Feedback for Correct Answer 1] The elastic properties of the vocal folds result in them colliding, closing off the airway.

[Feedback for Answer Choice 2] The elastic properties of the vocal folds result in them colliding, closing off the airway.

Muscular properties is not a term that is used in reference to the vocal folds.

[Feedback for Answer Choice 3] The elastic properties of the vocal folds result in them colliding, closing off the airway.

Ossification properties is not a term that is used in reference to the vocal folds.

[Feedback for Answer Choice 4] The elastic properties of the vocal folds result in them colliding, closing off the airway.

Cartilaginous properties is not a term that is used in reference to the vocal folds.

[Q3] Approximately how many harmonics are part of the human voice?

1. 10 2. 15 7 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

3. 25 4. 40 [correct] [Feedback for Answer Choice 1] The sound that results from vocal fold vibration is complex, consisting of a fundamental frequency and approximately 40 additional higher frequencies called harmonics. Ten is too few.

[Feedback for Answer Choice 2] The sound that results from vocal fold vibration is complex, consisting of a fundamental frequency and approximately 40 additional higher frequencies called harmonics. Fifteen is too few.

[Feedback for Answer Choice 3] The sound that results from vocal fold vibration is complex, consisting of a fundamental frequency and approximately 40 additional higher frequencies called harmonics.

Twenty-five is too few.

[Feedback for Correct Answer 4] The sound that results from vocal fold vibration is complex, consisting of a fundamental frequency and approximately 40 additional higher frequencies called harmonics.

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(b) Chapter 3 Application Exercises Application Exercise 3.1: Describe the effects of COVID-19 on the respiratory system.

Learning Objective 3.1: List and describe the principal structures and muscles of the respiratory system and differentiate resting tidal breathing from speech breathing.

Reference: Case Study: Jennifer (see page 59) [Q1] Use Case Study: Mike (page 59) to answer the following question: In this case study, Jennifer is described as manifesting in clinical signs and symptoms of COVID-19 disease. Which structures of the respiratory system are generally affected, and which were affected in Jennifer‟s specific case?

[Q1 Model Response] Infection often begins in the upper airway (nasal cavity, pharynx) epithelium. In a subset of patients like Jennifer, the virus infects the lower airways, particularly the alveolar epithelium.

[Q2] Use Case Study: Jennifer (page 59) to answer the following question: In this case study, what was the physiological impact of COVID-19 on Jennifer‟s respiratory system?

[Q2 Model Response] COVID-19 can cause diffuse damage that markedly impairs the ability of the alveoli to take in oxygen and release carbon dioxide. This leads to respiratory failure and other negative effects.

[Q3] Use Case Study: Jennifer (page 59) to answer the following question: In this case study, what can happen if a patient, like Jennifer, is unable to breathe on their own?

[Q3 Model Response] Mechanical ventilation may be necessary to provide and maintain adequate gas exchange and allow time for the lungs to heal.

Application Exercise 3.2: Describe the effects of intubation on the laryngeal system.

Learning Objective 3.2: List and describe the principal structures, muscles, and functions of the laryngeal system.

Reference: Case Study: Jennifer (see page 73) 9 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

[Q1] Use Case Study: Jennifer (page 73) to answer the following question: In this case study, Jennifer was intubated. What laryngeal structures can be affected when patients are intubated and how are they affected?

[Q1 Model Response] The trachea and vocal folds can be affected by edema, hematoma, or ulceration.

[Q2] Use Case Study: Jennifer (page 73) to answer the following question: As noted in this case study, what can happen to laryngeal muscles during long periods of disuse? How can this be improved?

[Q2 Model Response] Laryngeal muscles can become deconditioned and weakened. Behavioral speech and voice therapy are necessary to recondition muscles during speech production (e.g., practicing speech, voice production drills with feedback from the S LP).

Application Exercise 3.3: Describe the effects of upper airway system structural changes on the swallow.

Learning Objective 3.3: Briefly describe the structures and functions of the upper airway.

Reference: Case Study: Jennifer (see page 81) [Q1] Use Case Study: Jennifer (page 81) to answer the following question: In this case study, Jennifer‟s upper airway structures were negatively impacted for swallow function. What is one way this can manifest?

[Q1 Model Response] This can manifest in difficulties effectively and safely moving food and liquid from the mouth to the stomach.

[Q2] Use Case Study: Jennifer (page 81) to answer the following question: What is often the cause of swallowing dysfunction related to impairment of upper airway structures in patients like Jennifer?

[Q2 Model Response]

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Oropharyngeal muscle deconditioning and atrophy from disuse after lengthy periods of intubation, along with diminished sensation and proprioception of upper airway structures.

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(c) Chapter 3 Test Items 1. The study of the structures of the body and the relationship of these structures to one another is a. anatomy. b. physiology. c. kinesiology. d. biology.

2. The study of the functions of organisms and bodily structures is a. anatomy. b. physiology. c. kinesiology. d. biology.

3. Three physiological subsystems for speech are a. respiratory, laryngeal, and upper airway system. b. respiratory, articulatory, and propagating. c. muscular, aerodynamic, and acoustic. d. aerodynamic, acoustic, and receptive.

4. The

is the driving force for speech production.

a. respiratory system b. laryngeal system c. articulatory/resonating system d. propagating system 5. Which muscle is the bulk of each vocal fold? a. Posterior cricoarytenoid muscle b. Lateral cricoarytenoid muscle c. Thyroarytenoid muscle d. Cricothyroid muscle 6. The pulmonary apparatus consists of the a. lungs and diaphragm. b. pulmonary airways and diaphragm. c. chest wall and lungs. d. lungs and pulmonary airways.

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7. Inspiratory muscles are generally muscles are generally

, whereas expiratory .

a. contracted, relaxed b. controlled, reflexive c. above the diaphragm, below the diaphragm d. below the diaphragm, above the diaphragm 8. Expiratory muscles a. assist the diaphragm‟s movement back to its relaxed, dome-shaped configuration. b. are in direct contact with the diaphragm. c. are important for tidal breathing purposes only. d. are unable to be strengthened.

9. Which of the following is true? a. Resting tidal breathing rate decreases from birth to adulthood, related to more alveoli b. Maximum lung capacity is reached in early childhood and remains constant until early adulthood c. Respiratory function is not significantly affected by exercise, health, or smoking d. Resting tidal breathing rate increases from birth to adulthood, related to fewer alveoli 10.

is an air valve composed of cartilages, muscles, and other tissues; the principal sound generator for voice and speech production. a. Thyroid b. Vocal folds c. Larynx d. Pharynx

11. The primary biological function of the larynx is a. to produce speech. b. to prevent foreign substances from entering the trachea and lungs. c. to serve as an attachment point for inspiratory muscles. d. to lower during the swallow.

12. The larynx is oriented a. between the trachea and pharynx, appearing to be suspended from the hyoid bone. b. on top of the trachea, suspended from the thyroid cartilage.

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c. directly inferior to the base of the tongue, but superior to the pharynx. d. medial to the arytenoid cartilages.

13.

is the largest laryngeal cartilage; it forms the front and sides of the laryngeal skeleton and protects the inner components of the larynx. a. Thyroid cartilage b. Arytenoid cartilage c. Cricoid cartilage d. Hyoid cartilage

14. The anatomical name for the “Adam‟s apple” is the a. thyroid notch. b. thyroid prominence. c. thyroid protrusion. d. thyroid eminence.

15. The vocal folds

during respiration and during phonation.

a. adduct, abduct b. abduct, adduct c. elevate, depress d. depress, elevate 16. The upper airway system consists of a. the lungs, vocal folds, and nasal cavity. b. the larynx, pharynx, and oral cavity. c. the oral cavity, nasal cavity, and pharyngeal cavity. d. the pharyngeal cavity, laryngeal cavity, and lungs.

17. The is a resonant acoustic tube that shapes the sound energy produced by the respiratory and laryngeal systems into speech sounds. a. vocal tract b. larynx c. cricoid cartilage d. nasal cavity 18. The facial skeleton and cranium consist of

bones.

a. 17 b. 22

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c. 29 d. 32 19. Adults have

teeth.

a. 17 b. 22 c. 29 d. 32 20. The

is a muscular hydrostat.

a. tongue b. hyoid c. uvula d. velum 21. Velopharyngeal closure refers to a. elevation of the uvula into the nasal cavity. b. contact of the velum with the lateral and posterior pharyngeal walls. c. contact of the uvula and the epiglottis. d. elevation of the hard palate.

22. The bones of the skull reach adult size a. by age 8. b. by age 15. c. by age 22. d. the bones of the skull are constantly changing in size throughout the lifespan.

23. Newborns have a. more than twice the number of skull bones than adults. b. half the number of skull bones than adults. c. the same number of skull bones as adults. d. more than three times the number of skull bones than adults.

24. At what age does dentition emerge and at what age is secondary dentition complete? a. 6 months, 18 years b. 3 years, 22 years c. 3 years, 18 years d. 6 months, 22 years 15 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

25. Which of the following describes the role of the extrinsic laryngeal muscles? a. Shorten and lengthen the vocal folds b. Change the distance between the front of the thyroid cartilage and the arytenoid cartilages c. Bring the front portion of the vocal folds together d. Support and stabilize the larynx and change its position in the neck 26. How does the mandible articulate with the temporal bone? a. Condylar processes b. Zygomatic arch c. Temporomandibular joint d. Styloid process 27.

is/are the number of cycles of vocal fold vibration per second. a. Periodicity b. Frequency c. Harmonics d. Vibratory periods

28.

are whole-number multiples of the fundamental frequency. a. Harmonics b. Vibratory periods c. Habitual pitches d. Vocal registers

29. Describe how respiratory and swallowing coordination is affected by advanced age.

30. What are the structures of the chest wall?

31. Describe the structure and function of the diaphragm 32. Explain the process of inspiration as it relates to respiration.

33. Explain the process of expiration as it relates to respiration.

34. Describe the speech breathing process.

35. What are the three main cartilages of the larynx?

36. What are the front and back attachments of the vocal folds?

37. Describe four lifespan issues of the laryngeal system.

38. Explain why velar elevation is necessary.

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39. Name the three cavities of the pharynx.

40. What are the names for vocal tract resonances and their frequencies?

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(d) Chapter 3 Test Answer Key 1. A (see page 57, Introduction) 2. B (see page 57, Introduction) 3. A (see page 57, Introduction) 4. A (see page 58, section titled “The Respiratory System”) 5. C (see page 71, section titled “Muscles of the Larynx”) 6. D (see page 58, section titled “Structures of the Respiratory System”) 7. D (see page 61, section titled “Muscles of the Respiratory System”) 8. A (see page 65, section titled “Muscles of Expiration”) 9. A (see page 67, section titled “Lifespan Issues of the Respiratory System”) 10. C (see page 68, section titled “Structures of the Laryngeal System”) 11. B (see page 68, section titled “The Laryngeal System”) 12. A (see pages 68–69, section titled “Structures of the Laryngeal System”) 13. A (see page 69, section titled “Structures of the Laryngeal System”) 14. B (see page 69, section titled “Structures of the Laryngeal System”) 15. B (see page 70, section titled “Structures of the Laryngeal System”) 16. C (see page 75, section titled “The Upper Airway System”) 17. A (see pages 75–76, section titled “The Upper Airway System”) 18. B (see page 76, section titled “Structures of the Upper Airway System”) 19. D (see page 76, section titled “Teeth”) 20. A (see page 78, section titled “Tongue”) 21. B (see page 81, section titled “Velum”) 22. A (see page 82, section titled “Lifespan Issues of the Upper Airway System”) 23. A (see page 82, section titled “Lifespan Issues of the Upper Airway System”) 24. C (see page 82, section titled “Lifespan Issues of the Upper Airway System”) 25. D (see page 72, section titled “Muscles of the Larynx”) 26. C (see page 76, section titled “Structures of the Upper Airway System”) 27. B (see page 83, section titled “The Speech Production Process”) 28. A (see page 84, section titled “The Speech Production Process”) 29. Answers will vary, but should include some of the following points (see page 68, section titled “Lifespan Issues of the Respiratory System”): Respiratory and swallowing coordination is affected by advanced age, with increased inspiration both before and after the swallow in elderly individuals, 18 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

contributing to a lesser degree of airway protection.

30. Answers will vary, but should include some of the following points (see page 58, section titled “Structures of the Respiratory System”): Rib cage wall, diaphragm, abdominal wall, abdominal content.

31. Answers will vary, but should include some of the following points (see page 62, section titled “Muscles of Inspiration”): Main muscle of inspiration. Dome-shaped structure composed of a thin, flat, nonelastic central tendon and a broad rim of muscle fibers that course upward and insert into the edges of the central tendon. The central tendon is in direct contact with each lung. When the diaphragm contracts during inspiration, it pulls the central tendon downward and forward and flattens, enlarging the thorax vertically. Because the lungs and thorax are held together as a unit by pleural linkage, the lungs also expand when the thorax is expanded via contraction of the diaphragm.

32. Answers will vary, but should include some of the following points (see page 66, section titled “The Physiology of Tidal Breathing and Speech Breathing”): Diaphragm or other muscles of inspiration contract, the chest wall expands, causing the lungs to expand. Alveolar pressure decreases, creating a pressure gradient where pressure inside the pulmonary apparatus is below that of atmospheric pressure. Air then rushes into the lungs, equalizing alveolar pressure with atmospheric pressure.

33. Answers will vary, but should include some of the following points (see page 66, section titled “The Physiology of Tidal Breathing and Speech Breathing”): Decrease in the size of the rib cage wall, compression of the lungs, increase in pressure in the lungs, air rushes out to achieve equilibrium with atmospheric pressure. Expiration during quiet breathing is a relatively passive process; there isn‟t much need for expiratory muscular effort unless standing upright.

34. Answers will vary, but should include some of the following points (see page 66, section titled “The Physiology of Tidal Breathing and Speech Breathing”): Contraction of the diaphragm leads to rapid, forceful inspirations. Inspirations are much shorter than expirations. The amount of air inspired is greater than during resting tidal breathing. Inspiratory and expiratory muscles are both activated during speech.

35. Answers will vary, but should include some of the following points (see page 69, section titled “Structures of the Laryngeal System”): Thyroid, cricoid, and arytenoid cartilages.

36. Answers will vary, but should include some of the following points (see page 70, section titled “Structures of the Laryngeal System”): Front attachment: Midline of the thyroid cartilage. Back attachment: Arytenoid cartilages via the vocal ligament.

37. Answers will vary, but should include some of the following points (see page 74, 19 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

section titled “Lifespan Issues of the Laryngeal System”): The larynx is small and high in the neck in newborns. It reaches its final position between 10 and 20 years of age. The laryngeal cartilages increase in size and become less pliable with age. The vocal folds increase in length differentially for males and females. Female laryngeal cartilage never completely ossifies. The vocal ligament appears sometime between 1 and 4 years of age. The vocal folds atrophy and lose elasticity. In men, this is noted as an increase in pitch, and in women as decreased pitch with the contribution of hormone-related changes in menopause.

Transgender women using hormone therapies do not experience increases in fundamental frequency before or after menopause.

38. Answers will vary, but should include some of the following points (see page 81, section titled “Velum”): To prevent food from passing through the nasal cavity during swallowing and to prevent air from escaping through the nose and to allow sufficient air pressure to build up in the oral cavity for production of pressure sounds.

39. Answers will vary, but should include some of the following points (see page 79, section titled “Pharynx”): Nasopharynx, oropharynx, laryngopharynx 40. Answers will vary, but should include some of the following points (see page 85, section titled “The Speech Production Process”): Formants, formant frequencies

Article IV. Chapter 4 Test Item File

Introduction to Communication Disorders A Lifespan Evidence-Based Perspective 20 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Seventh Edition

Dr. Robert E. Owens, College of St. Rose Dr. Kimberly A. Farinella, Northern Arizona University

Prepared by

Dr. Sarah A. Dachtyl

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Section 4.01

Table of Contents

Chapter 4: Childhood Language Disorders

1

Learning Objective Quizzes

1

Application Exercises

11

Test Items

15

Test Answer Key

25

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Section 4.02 Chapter 4: Childhood Language Disorders (a) Chapter 4 Learning Objective Quizzes Learning Objective 4.1: Describe language development through the lifespan.

[Q1] Which child‟s perceptual ability is most likely restricted to their native language‟s speech sounds?

1. Kofi is 2 months old.

2. Andre is 4 months old.

3. Oliver is 6 months old.

4. Johannes is 9 months old. [correct] [Feedback for Answer Choice 1] Perceptual ability is usually restricted to a native language‟s speech sounds by 8–10 months. Two months is too early.

[Feedback for Answer Choice 2] Perceptual ability is usually restricted to a native language‟s speech sounds by 8–10 months. Four months is too early.

[Feedback for Answer Choice 3] Perceptual ability is usually restricted to a native language‟s speech sounds by 8–10 months. Six months is too early.

[Feedback for Correct Answer 4] Perceptual ability is usually restricted to a native language‟s speech sounds by 8–10 months.

[Q2] Which factor seems to be most important for vocabulary growth in young children?

1. The child‟s conversational experience with adults. [correct] 2. The development of the ability to categorize.

3. The ability to acquire locational terms.

4. The ability to acquire familial terms.

[Feedback for Correct Answer 1] The most important factor in vocabulary growth seems to be the child‟s conversational experience with adults.

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[Feedback for Answer Choice 2] The most important factor in vocabulary growth seems to be the child‟s conversational experience with adults. Semantic development partly reflects cognitive development of skills such as categorization.

[Feedback for Answer Choice 3] The most important factor in vocabulary growth seems to be the child‟s conversational experience with adults. Locational terms are a subset of the types of words children develop.

[Feedback for Answer Choice 4] The most important factor in vocabulary growth seems to be the child‟s conversational experience with adults. Familial terms are a subset of the types of words children develop.

[Q3] Which of the following children is most likely to use adult-like language form but with missing syntactic elements and a lack of some pragmatic skills due to their age?

1. Missy is 1 year old.

2. Crystal is 2 years old.

3. Rollie is 3 years old.

4. James is 5 years old [correct] [Feedback for Answer Choice 1] Five-year-olds with typically developing language use very adult-like language form, although many subtle syntactic structures are missing and they have not acquired some of the pragmatic skills necessary to become truly effective communicators. Missy is too young.

[Feedback for Answer Choice 2] Five-year-olds with typically developing language use very adult-like language form, although many subtle syntactic structures are missing and they have not acquired some of the pragmatic skills necessary to become truly effective communicators. Crystal is too young.

[Feedback for Answer Choice 3] Five-year-olds with typically developing language use very adult-like language form, although many subtle syntactic structures are missing and they have not acquired some of the pragmatic skills necessary to become truly effective communicators. Rollie is too young.

[Feedback for Correct Answer 4]

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Five-year-olds with typically developing language use very adult-like language form, although many subtle syntactic structures are missing and they have not acquired some of the pragmatic skills necessary to become truly effective communicators.

Learning Objective 4.2: Characterize language disorders and associated disorders.

[Q1] Kareem participated in a research study and underwent brain imaging. The results indicated that there was brain symmetry in the left and right hemispheres in language processing regions. This is most likely related to which of the following?

1. Social communication disorder (S CD) 2. Developmental language disorder (D LD) [correct] 3. Autism spectrum disorder (A SD) 4. Intellectual disability (I D) [Feedback for Answer Choice 1] For children with DLD, brain imaging indicates brain symmetry in the left and right hemispheres, unlike the usual asymmetry of left-side predominance in language processing regions.

[Feedback for Correct Answer 2] For children with DLD, brain imaging indicates brain symmetry in the left and right hemispheres, unlike the usual asymmetry of left-side predominance in language processing regions.

[Feedback for Answer Choice 3] For children with DLD, brain imaging indicates brain symmetry in the left and right hemispheres, unlike the usual asymmetry of left-side predominance in language processing regions.

[Feedback for Answer Choice 4] For children with DLD, brain imaging indicates brain symmetry in the left and right hemispheres, unlike the usual asymmetry of left-side predominance in language processing regions.

[Q2] Dominic is a 5-year-old boy who exhibits difficulty with interaction skills, pragmatics, playing with other children, and resolving conflict on the playground and in the classroom. His most likely diagnosis is: 1. Dyslexia 2. Selective mutism 3. Social communication disorder (SCD) [correct] 4. Developmental language disorder (DLD) 3 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

[Feedback for Answer Choice 1] The characteristics of SCD include problems with communication for social purposes, including deficits in interactional skills, social cognition, pragmatics, and language.

Cooperative tasks such as play and conflict resolution may be difficult. Dyslexia is a disorder of written language.

[Feedback for Answer Choice 2] The characteristics of SCD include problems with communication for social purposes, including deficits in interactional skills, social cognition, pragmatics, and language.

Cooperative tasks such as play and conflict resolution may be difficult. In selective mutism, children do not speak in specific situations although they speak in others.

[Feedback for Correct Answer 3] The characteristics of SCD include problems with communication for social purposes, including deficits in interactional skills, social cognition, pragmatics, and language.

Cooperative tasks such as play and conflict resolution may be difficult.

[Feedback for Answer Choice 4] The characteristics of SCD include problems with communication for social purposes, including deficits in interactional skills, social cognition, pragmatics, and language.

Cooperative tasks such as play and conflict resolution may be difficult. This description does not match DLD as it relates more specifically to social language difficulties.

[Q3] Josiah is an 8-year-old boy in second grade. His prosody is described as mechanical, with stress, intonation, loudness, pitch, and rate affected. His most likely diagnosis is: 1. specific learning disability.

2. intellectual disability.

3. developmental language disorder 4. autism spectrum disorder. [correct] [Feedback for Answer Choice 1] In children with autism spectrum disorder, prosodic features such as stress, intonation, loudness, pitch, and rate are often affected, giving the impression of a mechanical quality. These are not typical features of specific learning disability.

[Feedback for Answer Choice 2] In children with autism spectrum disorder, prosodic features such as stress, intonation, loudness, pitch, and rate are often affected, giving the impression of a mechanical quality. These are not typical features of intellectual disability.

[Feedback for Answer Choice 3]

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In children with autism spectrum disorder, prosodic features such as stress, intonation, loudness, pitch, and rate are often affected, giving the impression of a mechanical quality. These are not typical features of developmental language disorder.

[Feedback for Correct Answer 4] In children with autism spectrum disorder, prosodic features such as stress, intonation, loudness, pitch, and rate are often affected, giving the impression of a mechanical quality.

[Q4] Which of the following individuals is at greatest risk of sustaining a traumatic brain injury?

1. Kayla is 6 years old.

2. Jason is 10 years old.

3. Alexa is 12 years old.

4. Benjamin is 17 years old. [correct] [Feedback for Answer Choice 1] At greatest risk for brain injury are those age 0–4 and 15–19. Kayla does not fall within those ranges.

[Feedback for Answer Choice 2] At greatest risk for brain injury are those age 0–4 and 15–19. Jason does not fall within those ranges.

[Feedback for Answer Choice 3] At greatest risk for brain injury are those age 0–4 and 15–19. Alexa does not fall within those ranges.

[Feedback for Correct Answer 4] At greatest risk for brain injury are those age 0–4 and 15–19.

[Q5] Caleb was recently diagnosed with schizophrenia. How likely is it that he will experience language abnormalities?

1. The likelihood is approximately 15%.

2. The likelihood is approximately 25%.

3. The likelihood is approximately 55%. [correct] 4. The likelihood is approximately 75%.

[Feedback for Answer Choice 1]

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Approximately 55% of children with schizophrenia have language abnormalities, including language delay, especially in pragmatics. Fifteen percent is not high enough.

[Feedback for Answer Choice 2] Approximately 55% of children with schizophrenia have language abnormalities, including language delay, especially in pragmatics. Twenty-five percent is not high enough.

[Feedback for Correct Answer 3] Approximately 55% of children with schizophrenia have language abnormalities, including language delay, especially in pragmatics.

[Feedback for Answer Choice 4] Approximately 55% of children with schizophrenia have language abnormalities, including language delay, especially in pragmatics. Seventy-five percent is too high.

Learning Objective 4.3: Explain the process of assessment in language disorder.

[Q1] Because Elu speaks a nonmainstream American English dialect, his SLP chooses to use during his evaluation because it accounts for language variations.

1. standardized assessment 2. dialectal scoring [correct] 3. normative data 4. a standardized language screening measure [Feedback for Answer Choice 1] Dialectal scoring accounts for language variations related to nonmainstream American English dialects. Standardized assessments do not have that flexibility and are not the most appropriate choice in this scenario.

[Feedback for Correct Answer 2] Dialectal scoring accounts for language variations related to nonmainstream American English dialects.

[Feedback for Answer Choice 3] Dialectal scoring accounts for language variations related to nonmainstream American English dialects. Normative data often does not exist for all nonmainstream American English dialects and is not the most appropriate choice in this scenario.

[Feedback for Answer Choice 4] Dialectal scoring accounts for language variations related to nonmainstream American English dialects. Standardized language screening measures would not be appropriate for this purpose.

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[Q2] Using a combination of tasks such as using children‟s books for shared story retelling in which a familiar story element is altered along with comprehension questions can identify as high as what percentage of children with language disorders?

1. 78% 2. 83% 3. 96% [correct] 4. 100% [Feedback for Answer Choice 1] A combination of tasks using children‟s books, such as shared story retelling in which a familiar story element is altered and comprehension questions, may be effective in identifying 96% of children with language disorders. Seventy-eight percent is an underestimate.

[Feedback for Answer Choice 2] A combination of tasks using children‟s books, such as shared story retelling in which a familiar story element is altered and comprehension questions, may be effective in identifying 96% of children with language disorders. Eighty-three percent is an underestimate.

[Feedback for Correct Answer 3] A combination of tasks using children‟s books, such as shared story retelling in which a familiar story element is altered and comprehension questions, may be effective in identifying 96% of children with language disorders.

[Feedback for Answer Choice 4] A combination of tasks using children‟s books, such as shared story retelling in which a familiar story element is altered and comprehension questions, may be effective in identifying 96% of children with language disorders. One hundred percent is an overestimate.

[Q3] Children produce more complex utterances while engaging in which activity?

1. Talking with unfamiliar adults 2. Telling stories [correct] 3. Free play 4. Talking with parents in an unfamiliar setting [Feedback for Answer Choice 1] Although young children engaged in free play produce more utterances than those telling stories, they produce more complex utterances while telling stories and in 7 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

conversation. Talking with unfamiliar adults is unlikely to result in more complex utterances.

[Feedback for Correct Answer 2] Although young children engaged in free play produce more utterances than those telling stories, they produce more complex utterances while telling stories and in conversation.

[Feedback for Answer Choice 3] Although young children engaged in free play produce more utterances than those telling stories, they produce more complex utterances while telling stories and in conversation. Free play is unlikely to result in more complex utterances.

[Feedback for Answer Choice 4] Although young children engaged in free play produce more utterances than those telling stories, they produce more complex utterances while telling stories and in conversation. Talking with parents in an unfamiliar setting is unlikely to result in more complex utterances.

Learning Objective 4.4: Describe the overall design of language intervention.

[Q1] Adora is a 9-year-old child who has been diagnosed with a language disorder. She is most likely to acquire, maintain, and generalize new grammatical forms with which teaching technique?

1. Peer modeling 2. Implicit methods 3. Adult modeling 4. Explicit instruction [correct] [Feedback for Answer Choice 1] Explicit instruction makes a child consciously aware of the underlying language pattern.

Children are more likely to acquire, maintain, and generalize novel grammatical forms when taught with explicit instruction. Peer modeling would not have the same effects.

[Feedback for Answer Choice 2] Explicit instruction makes a child consciously aware of the underlying language pattern.

Children are more likely to acquire, maintain, and generalize novel grammatical forms when taught with explicit instruction. Implicit methods would not have the same effects.

[Feedback for Answer Choice 3] Explicit instruction makes a child consciously aware of the underlying language pattern.

Children are more likely to acquire, maintain, and generalize novel grammatical forms when taught with explicit instruction. Adult modeling would not have the same effects.

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[Feedback for Correct Answer 4] Explicit instruction makes a child consciously aware of the underlying language pattern.

Children are more likely to acquire, maintain, and generalize novel grammatical forms when taught with explicit instruction.

[Q2] Within treatment sessions, more generalization.

results in more stable

1. active involvement [correct] 2. parent correction 3. extrinsic rewards 4. nonverbal cues [Feedback for Correct Answer 1] The level of a child‟s active engagement is directly related to their language gains. More active involvement results in more stable generalization.

[Feedback for Answer Choice 2] The level of a child‟s active engagement is directly related to their language gains. More active involvement results in more stable generalization. More parent correction does not have the same effect.

[Feedback for Answer Choice 3] The level of a child‟s active engagement is directly related to their language gains. More active involvement results in more stable generalization. More extrinsic rewards do not have the same effect.

[Feedback for Answer Choice 4] The level of a child‟s active engagement is directly related to their language gains. More active involvement results in more stable generalization. More nonverbal cues do not have the same effect.

[Q3] What is the most likely level of benefit or effect of early intervention?

1. Minimal improvement 2. A slight decline in skills due to increased awareness and embarrassment 3. Frustration on the part of the child 4. Very beneficial effects [correct] [Feedback for Answer Choice 1] Early intervention, especially for children with I D and ASD, can be very beneficial.

Improvement is more significant than merely minimal improvement.

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[Feedback for Answer Choice 2] Early intervention, especially for children with I D and ASD, can be very beneficial. There is not typically a decline in skills.

[Feedback for Answer Choice 3] Early intervention, especially for children with I D and ASD, can be very beneficial.

Frustration may be present, but the main effect is a beneficial one.

[Feedback for Correct Answer 4] Early intervention, especially for children with I D and ASD, can be very beneficial.

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(b) Chapter 4 Application Exercises Application Exercise 4.1: Examples of early intentions of children.

Learning Objective 4.1: Describe language development through the lifespan.

Reference: Table 4.2 [Q1] Use Table 4.2 (page 95) to answer the following question: Give examples of the early intention of protesting.

[Q1 Model Response] The child says, “No” or the name of the item while pushing it away, turning away, and/or making a frowning face.

[Q2] Use Table 4.2 (page 95) to answer the following question: Give examples of the early intention of content questioning.

[Q2 Model Response] The child asks, “What?” or “That?” or “What?” while pointing and/or looking at an item.

[Q3] Use Table 4.2 (page 95) to answer the following question: Give examples of the early intention of verbal accompaniment.

[Q3 Model Response] Speech accompanies some action, such as “where” when swung or “uh-oh” when something spills.

Application Exercise 4.2: Personal description of an experience with learning disability.

Learning Objective 4.2: Characterize language disorders and associated disorders.

Reference: Pearson e-Text Video Example 4.9 [Q1] Use Pearson e-Text Video example 4.9 to answer the following question: What was the speaker‟s experience when taking her 9th grade science tests?

[Q1 Model Response]

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She felt confident when taking the tests and thought she did well. When she got the tests back, she had done poorly and she thought the questions had asked something different.

[Q2] Use Pearson e-Text Video example 4.9 to answer the following question: How did the speaker go from failing beginning Biology to excelling in advance placement (AP) Biology? How does this make sense in terms of her later-diagnosed learning disability?

[Q2 Model Response] Beginning Biology relied on reading and recalling text, and the speaker was later identified as having a reading disability. A P Biology relied on visual representations and interactive labs, where she experienced more success because of her strength in visual memory.

[Q3] Use Pearson e-Text Video example 4.9 to answer the following question: How did the speaker‟s learning challenges affect her personally?

[Q3 Model Response] The speaker lost hope academically and ran out of ideas of how to do better. She began to notice she would forget things her friends told her. She became depressed and relationships were affected. She experienced panic attacks, became socially isolated, and experienced suicidal ideation.

[Q4] Use Pearson e-Text Video example 4.9 to answer the following question: What was the barrier for the speaker to be tested for learning disability and how was that overcome?

[Q4 Model Response] The testing for a psychoeducational evaluation cost $1200, but the science program she applied to covered the cost.

Application Exercise 4.3: Evidence-based practice for childhood language disorders.

Learning Objective 4.4: Describe the overall design of language intervention.

Reference: Box 4.4 (see pages 133–134) [Q1] Use Box 4.4 (see pages 133–134) to answer the following question: 12 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Given the information in Box 4.4 for evidence-based practice for childhood language disorders, describe two main points for treatment for children with autism spectrum disorder.

[Q1 Model Response] 1) Effective interventions are characterized by early intervention and intensive and individualized instruction. 2) Both structural behavioral approaches and naturalistic approaches are effective in replacing challenging behavior with social interactions, although no method works with all children with A SD. 3) Approximately two-thirds of children make significant measurable gains with intervention. 4) The Picture Exchange Communication System (P ECS), in which a picture is used to request items, demonstrates only small to moderate gains in communication and small to negative gains in speech. Gains may be enhanced if others, such as peers with T DL, are taught to be responsive listeners. 4) Although video-modeling is an effective strategy for teaching some social interactional behaviors, we still need exploration of the efficacy of other methods.

[Q2] Use Box 4.4 (see pages 133–134) to answer the following question: Given the information in Box 4.4 for evidence-based practice for childhood language disorders, describe two main points for treatment for preschool children.

[Q2 Model Response] 1) Speech and language interventions are most effective for children with phonological or expressive vocabulary difficulties. 2) Parent-implemented language interventions have a significant, positive impact on both receptive language and expressive syntactic skills. 3) Intervention of more than 8 weeks results in better outcomes than shorter intervention. 4) Seventy percent of preschool children with language impairments make significant measurable gains with intervention.

[Q3] Use Box 4.4 (see pages 133–134) to answer the following question: Given the information in Box 4.4 for evidence-based practice for childhood language disorders, describe two main points for school-age and adolescent syntax/morphology and/or semantics/vocabulary treatment.

[Q3 Model Response] 1) A paucity of research exists, and we do not yet have evidence on the best possible technique for effective vocabulary instruction for children in the early elementary grades.

2) Collaborating with teachers on large-group instruction and slowed presentation rate can positively impact vocabulary development. 3) Interactive conversational strategies may be somewhat helpful for improving receptive and expressive vocabulary. 4) There do not seem to be clear differences in outcome between the various methods used to assist children with word finding. 5) Moderately large to large effects follow use of 13 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

imitation, modeling, or modeling plus evoked production strategies. 6) Computerized input strategies alone have not demonstrated extensive benefit as yet.

[Q4] Use Box 4.4 (see pages 133–134) to answer the following question: Given the information in Box 4.4 for evidence-based practice for childhood language disorders, describe two main points related to language processing and/or pragmatics and discourse treatment.

[Q3 Model Response] 1) Computer intervention using modified speech stimuli or speech and language games does not improve performance. 2) Direct instruction on topic initiation and group entry behaviors can yield moderately large to large effects for students with social communication deficits. 3) It is possible to teach social skills to adolescents with ASD, although the data are not sufficient to identify the most effective method of intervention.

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(c) Chapter 4 Test Items 1. At what age do rituals and game playing emerge? a. At birth b. 3–4 months c. 6–9 months d. 12–18 months 2. At about 8 to 9 months, infants develop

in interactions.

a. reciprocity b. stimulus-response sequence c. object permanence d. intentionality 3. The first meaningful word occurs around

.

a. 6 months b. 12 months c. 18 months d. 24 months 4. Speech perception at 6 months is related to later

.

a. reading abilities b. speaking fluency c. word/phrase understanding and production d. writing abilities 5. By , children produce about 50 single words and begin to combine words predictably. a. 12 months b. 18 months c. 24 months d. 36 months 6. By age 2, children have an expressive vocabulary of about a. 50–100 words. b. 100–150 words. c. 150–300 words. d. 300–500 words.

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7. Each child has a personal dictionary, or environment.

that reflects his/her

a. semantic corpus b. lexicon c. semantic map d. definition list 8. If a preschool-aged child uses utterances that differ only slightly from previous utterances (e.g., “doggies are yucky,” “kitties are yucky”), they are using a. lexical retrieval. b. repetition. c. reformulation. d. substitution.

9. Preschool-aged children can recount the past and remember short stories because of a. improved speech articulation. b. increased memory and language skills. c. improved caregiver models. d. increased fluency.

10. What is reformulation? a. Caregivers repeat the child‟s utterances in mature form b. Children repeat phrases using the same word in each sentence c. Children are taught to self-correct their errors d. Children infer meanings based on context 11. How long can preschool-aged children maintain a conversation? a. 1–2 turns b. 2–3 turns c. 5–6 turns d. 7–8 turns 12. In preschool HeadStart programs, what percentage of children use a language other than English? a. 5% b. 20% c. 30% d. 45% 16 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

13.

is inferring meaning from context and using the word in a similar manner. a. Reformulation b. Figurative language c. Fast mapping d. Metalinguistics

14. About 90% of adult syntax is acquired by age a. 5. b. 8. c. 12. d. 15.

15. Language becomes more complex as it becomes longer, and can be calculated in a. mean length of utterance. b. syntactical complexity units. c. morphological counts. d. frequency counts.

16.

allow(s) the child to consider language in the abstract, make judgments about its correctness, and create verbal contexts. a. Pragmatics development b. Generalization c. Representation d. Metalinguistic skills

17. For school-aged children, language development a. increases dramatically. b. slows and begins to stabilize. c. can decrease because of poor peer models. d. can decrease because of interference effects.

18.

are sayings that do not always mean what they seem to mean, as in idioms. a. Figurative language b. Implicitures c. Multiple meanings d. Inferences 17 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

19. By high school, children understand approximately a. 10,000 words. b. 20,000 words. c. 40,000 words. d. 60,000 words.

20. Multiple word meanings are acquired a. during the preschool years. b. during adolescence. c. during adulthood. d. in early childhood.

21. By age , children with TDL can use most verb tenses, possessive pronouns, and conjunctions. a. 3 b. 5 c. 7 d. 10 22. Risk factors for include being a boy, low S ES, not being an only child, older maternal age at birth, moderately low birth weight, low quality parenting, receipt of no day care or for less than 10 hr/week, and hearing or attention problems. a. autism b. Down syndrome c. cognitive impairment d. being a late talker 23. Children who are identified as late talkers at 24–31 months a. tend to recover spontaneously. b. are diagnosed with cognitive impairments by school-age. c. still have a weakness in language-related skills in late adolescence. d. have executive dysfunction.

24. Severity of intellectual disability is usually based on a. IQ and daily living skills. b. adaptive behaviors alone. c. language abilities. d. sustained attention measures.

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25. When should intervention begin for those with intellectual developmental disorders? a. During the toddler years b. When the child is preschool aged c. As soon as possible d. Intervention does not help those with intellectual disabilities 26. Children with Down syndrome and Fragile X syndrome both have a. mild language delays. b. moderate-severe language delays. c. profound language delays. d. very different levels of language delay.

27.

are manifested in the imperfect ability to listen, think, speak, read, write, spell, and do mathematical calculations. a. Learning disabilities b. Cognitive impairments c. Speech-language impairments d. Syndromes

28. Approximately

of all school-age children have L D.

a. 1–2% b. 5–15% c. 15–25% d. 25–35% 29.

is an underlying neurological impairment in executive function that regulates behavior, causing impulsiveness. a. Autism b. Cluttering c. Specific language impairment d. Attention Deficit Hyperactivity Disorder

30. Descriptive measures such as allow an SLP to explore a child‟s strengths and weaknesses during assessment. a. language sampling b. standardized tests c. criterion-referenced tests d. dynamic assessments 19 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

31. What is the prevalence of language disorders in children with no known origin nor association with other existing disorders? a. 7.58% b. 10.85% c. 13.75% d. 15.57% 32.

may unintentionally prejudice testing results against the child. a. Prognostic factors b. The case history c. Parent interviews d. Unfamiliar tasks

33.

is an active process that allows limited information to be held in a temporary accessible state while cognitive processing occurs. a. Short term memory b. Working memory c. Long term memory d. Procedural memory

34. Most SLPs collect approximately

utterances for language sample analysis.

a. 25 b. 50 c. 100 d. 150 35.

is a reliable and valid measure of general language development through age 10 for children with DLD. a. Average number of clauses per sentence b. MLU c. Number of different words used d. Noun/verb ratio

36. Children with ASD are identified by the time they are a. born. b. 6 months old. c. 2–3 years old. d. 5–7 years old.

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37. The incidence of ASD among children is a. 1 in 22. b. 1 in 44. c. 1 in 110. d. 1 in 230.

38. Approximately 25% of children with ASD exhibit a. IDD. b. ADHD. c. DLD. d. SLD. 39. Between and throughout their lives.

of individuals with severe ASD remain nonspeaking

a. 2%, 5% b. 15%, 30% c. 25%, 60% d. 50%, 80% 40. Some individuals with ASD may have immediate or delayed . a. special stories b. echolalia c. recall d. scripts 41.

is the synchrony of intervention strategies and techniques with the cultural values, beliefs, and behaviors of a community. a. Cultural congruency b. Cultural sensitivity c. Cultural responsiveness d. Cultural competence

42. Approximately, experienced a T BI.

children and adolescents in the U.S. have

a. 100,000 b. 500,000 c. 1 million d. 2 million 21 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

43. Psychological maladjustment or acting-out behaviors called may occur after TBI. a. social disinhibition b. confabulation c. anosognosia d. prosopagnosia 44. Deficits in BI.

are most likely to remain long after the injury in T

a. syntax b. semantics c. pragmatics d. morphology 45.

is relatively unaffected in TBI. a. Form b. Content c. Use d. Pragmatics

46. Children are more likely to acquire, maintain, and generalize novel grammatical forms when taught with a. Teach-Model-Coach-Review. b. corrective feedback. c. incidental teaching. d. explicit instruction.

47. In they speak in others.

, children do not speak in specific situations although

a. deafness b. selective mutism c. language delay d. autism 48. Screening tests are used to a. determine the presence or absence of a language problem. b. qualify a student for special education services. c. quantify the degree of language impairment d. guide treatment decisions 22 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

49.

refers to the movement between two languages. a. Bilingualism b. Code switching c. Parallelism d. Dialect changing

50.

is probing performance to identify possible intervention procedures. a. Diagnostic therapy b. Response to intervention c. Dynamic assessment d. Language sampling

51. Adults with severe will most likely require continued intervention for language and communication deficits and a range of educational and vocational needs. a. ADHD b. ASD/IDD c. DLD d. FASD 52. What are language disorders?

53. How is intention to communicate noted?

54. Define “representation” and “symbolization.”

55. In what order do wh- words develop?

56. Describe the changes in language use during adolescence.

57. Intellectual developmental disorder consists of what three characteristics?

58. Explain some areas of communication in which individuals with intellectual developmental disorders will have difficulty.

59. What three main assessment components should be present when evaluating English learners and nonmainstream dialectal speakers?

60. In repeat it compulsively.

, children become fixed on a single task or behavior and

61. What are four behaviors that are noted during the observation portion of assessment?

62. Describe lifespan issues that affect individuals with learning disabilities.

63.

refers to the organizing and directing function of the brain.

64. What are five lifespan issues of children with DLD? 23 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

65. List four language characteristics of children with DLD. 66. What are three language tasks that can be used for language sampling?

67. Incidence of ASD is highest in which populations?

68. What is the most effective intervention approach for older school-age and adolescents with deficits in syntax?

69. Three variables related to degree of impairment related to TBI include: 70. Describe lifespan issues related to TBI. 71. What are the language characteristics of children who have been maltreated?

72. Name three language features of children with F ASD. 73. What can be expected in language development in those who receive a cochlear implant?

74.

is the persistent difficulty in the social use of verbal and nonverbal communication and may include problems in all of those areas.

75. Describe at least three language characteristics of individuals with social communication disorder (SCD).

76. What factors are important in target selection and sequence of teaching?

77. What are the basic tenets of good teaching behavior for language intervention in children?

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(d) Chapter 4 Test Answer Key 1. B (see page 93, section titled “Pre-Language”) 2. D (see page 93, section titled “Pre-Language”) 3. B (see page 93, section titled “Pre-Language”) 4. C (see page 93, section titled “Pre-Language”) 5. B (see page 94, section titled “Toddler Language”) 6. C (see page 95, section titled “Content and Form”) 7. B (see page 95, section titled “Content and Form”) 8. D (see page 96, section titled “Preschool Language”) 9. B (see page 96, section titled “Preschool Language”) 10. A (see page 96, section titled “Preschool Language”) 11. B (see page 96, section titled “Use”) 12. C (see page 123, section titled “Assessment of English Learners and Nonmainstream Dialectal Speakers”) 13. C (see page 97, section titled “Content”) 14. A (see page 98, section titled “Form”) 15. A (see page 98, section titled “Form”) 16. D (see page 99, section titled “School-Age and Adolescent Language”) 17. B (see page 99, section titled “School-Age and Adolescent Language”) 18. A (see page 100, section titled “Content”) 19. D (see page 100, section titled “Content”) 20. B (see page 100, section titled “Content”) 21. B (see page 100, section titled “Form”) 22. D (see page 102, section titled “Language Disorders”) 23. C (see page 101, section titled “Language Disorders”) 24. A (see page 112, section titled “Intellectual Developmental Disorder”) 25. C (see page 113, section titled “Lifespan Issues”) 26. B (see page 114, section titled “Language Characteristics”) 27. A (see page 115, section titled “Learning Disabilities”) 28. B (see page 115, section titled “Learning Disabilities”) 29. D (see pages 116-117, section titled “Learning Disabilities”) 30. A (see page 126, section titled “Testing”) 25 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

31. A (see page 103, section titled “Language Disorders in the Absence of Other Disorders”) 32. D (see page 127, section titled “Testing”) 33. B (see page 105, section titled “Lifespan Issues”) 34. B (see page 129, section titled “Sampling”) 35. B (see page 130, section titled “Sampling”) 36. C (see page 110, section titled “Lifespan Issues”) 37. B (see page 109, section titled “Autism Spectrum Disorder”) 38. A (see page 109, section titled “Autism Spectrum Disorder”) 39. C (see page 111, section titled “Language Characteristics”) 40. B (see page 111, section titled “Language Characteristics”) 41. A (see page 131, section titled “Considerations for Children with Culturally and Linguistically Diverse Backgrounds”) 42. C (see page 118, section titled “Brain Injury”) 43. A (see page 118, section titled “Brain Injury”) 44. C (see page 119, section titled “Language Characteristics”) 45. A (see page 119, section titled “Language Characteristics”) 46. D (see page 136, section titled “Intervention Procedures”) 47. B (see page 120, section titled “Other Language Disorders”) 48. A (see page 124, section titled “Referral and Screening”) 49. B (see page 130, section titled “Sampling”) 50. C (see page 128, section titled “Testing”) 51. B (see pages 138–139, section titled “Intervention Through the Lifespan”) 52. Answers will vary, but should include some of the following points (see page 90, Introduction): A heterogeneous group of developmental and/or acquired disorders and/or delays that affect the use of spoken or written language for comprehension and/or production and may involve the form, content, and/or function of language.

Language differences are not disorders and so do not require clinical intervention; however, elective intervention is possible at a client‟s request.

53. Answers will vary, but should include some of the following points (see page 93, section titled “Pre-Language”): In multiple ways, such as gesture, eye contact, consistent sound/intonation patterns for specific intentions, and persistent attempts to communicate.

54. Answers will vary, but should include some of the following points (see page 94, section titled “Pre-Language”): 26 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Representation is the process of having one thing stand for another. Symbolization is using an arbitrary symbol to stand for another.

55. Answers will vary, but should include some of the following points (see page 98, section titled “Form”): What and where are first, followed by who, which and whose, and finally when, why and how.

56. Answers will vary, but should include some of the following points (see pages 99– 100, section titled “Use”): Conversational skills continue to develop and narratives expand into mature storytelling. Learn effective ways to introduce new topics, to continue, and to end conversations. They can make relevant comments and adapt roles and moods to fit situations. Teens demonstrate more affect and discuss topics infrequently mentioned at home. The number of turns on topic increases. Interrupting increases but is in the form of asking questions or otherwise moving a topic along. Narratives, both in conversation and in writing, gain the elements needed.

57. Answers will vary, but should include some of the following points (see page 112, section titled “Intellectual Developmental Disorder”): Deficits in intellectual functioning confirmed by clinical evaluation and individualized standard IQ testing; deficits in adaptive functioning that significantly hinder an individual‟s independence and ability to meet their social responsibilities; onset during childhood.

58. Answers will vary, but should include some of the following points (see pages 114– 115, section titled “Language Characteristics”): Children with DS and FXS have moderate to severe delays in communication in all areas of language. Those with D S have more significant phonological differences.

Those with FXS use more repetitive speech. Children with IDD are less likely to request clarification when communication breaks down. Boys with ASD and boys and girls with FXS co-occurring with ASD have more off-topic language and more repetitions. Boys who have FXS with and without ASD and boys with DS produce shorter, less complex utterances. For approximately half the population with IDD, language comprehension and/or production is below the level of cognition. Children with IDD produce shorter, more immature language forms. In later development, the paths begin to differ more from typical development.

59. Answers will vary, but should include some of the following points (see page 124, section titled “Assessment of English Learners and Nonmainstream Dialectal Speakers”): Published tests in both languages, spontaneous and elicited language samples in various settings with differing partners, and dynamic assessment procedures that are more open ended and include descriptions of a child‟s use of both English and the child‟s first language.

60. Answers should include the following (see page 115, section titled “Learning Disabilities”): 27 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Perseveration 61. Answers will vary, but should include some of the following points (see page 126, section titled “Observation”): The child‟s interests, topics, style, methods of communicating, parental sensitivity to a child‟s communication attempts, parental responding to those attempts.

62. Answers will vary, but should include some of the following points (see page 117, section titled “Lifespan Issues”): As preschoolers, children with LD may exhibit little interest in language or books.

Linguistic demands of the classroom are often well above language abilities. Many require the services of special educators, SLPs, and reading specialists. Children with LD can be successful in the regular classroom if some adaptation is made.

Some seem to outgrow aspects of their disability, some require lifelong adaptations, and still others continue to experience significant difficulty.

63. Answers should include the following (see page 105, section titled “Lifespan Issues”): Executive function 64. Answers will vary, but should include some of the following points (see page 104, section titled “Lifespan Issues”): At high risk for reading disorders, low academic achievement and increased risk for stopping education at high school, peer relationship difficulties, heightened risk for peer victimization and bullying, increased risk for being identified as having ADHD, increased social anxiety, perceived more negatively by teachers and peers, increased emotional difficulties, less independent, less socially confident, brain imaging indicates brain symmetry and less efficient patterns of functioning, marked deficits in WM and executive function.

65. Answers will vary, but should include some of the following points (see pages 105– 106, section titled “Language Characteristics”): Begin to use single words and to combine words later than children with TDL, deficit in the ability to detect regularities in language, may shorten sentences by omitting morphological endings, deficits in ability to recognize and express emotions, social perception skills affect communication abilities, have limited semantic knowledge and frequent word errors, more effortful cognition during language comprehension, pronouns are difficult.

66. Answers will vary, but should include some of the following points (see page 128, section titled “Sampling”): Conversation, narration, explanation, and interview 67. Answers will vary, but should include some of the following points (see page 109, section titled “Autism Spectrum Disorder”): Males, those who have a family history of autism.

68. Answers will vary, but should include some of the following points (see page 130, 28 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

section titled “Intervention”): An integrated approach in which naturalistic stimulation approaches are supplemented with deductive teaching procedures in which the child is presented a rule along with models.

69. Answers will vary, but should include some of the following points (see page 118, section titled “Brain Injury”): Extent and site of lesion, age at onset, age of the injury 70. Answers will vary, but should include some of the following points (see pages 118– 119, section titled “Lifespan Issues”): After the accident, the individual may be unconscious. After regaining consciousness, disorientation and memory loss can occur. May be accompanied by physical disability and personality changes. Neural recovery is often unpredictable and irregular. Young children often recover quickly but experience difficulties learning new information and may exhibit severe, long-lasting problems. Older children have more to recover from memory but less new information to learn.

Young children with TBI may perform within average limits on standardized language tests but show differences later in more complex language skills, such as reading comprehension and pragmatics. Older children have more to recover from memory but less new information to learn.

71. Answers will vary, but should include some of the following points (see page 121, section titled “Other Language Disorders”): Pragmatics is the greatest area of difficulty, although all areas of language can be affected. Maltreated children demonstrate consistently poorer language skills with respect to receptive vocabulary, expressive language, and receptive language.

72. Answers will vary, but should include some of the following points (see page 120, section titled “Other Language Disorders”): Language delay, echolalia, and poor comprehension 73. Answers will vary, but should include some of the following points (see page 120, section titled “Other Language Disorders”): Children who receive cochlear implants have relatively typical language development. Those implanted later have an initial advantage of maturity that enhances language growth, but those implanted earlier begin to develop spoken language at an ever-increasing rate that eclipses those implanted earlier.

74. Answers should include the following (see page 106, section titled “Social Communication Disorder”): Social communication disorder 75. Answers will vary, but should include some of the following points (see pages 107– 108, section titled “Language Characteristics”): Problems with communication for social purposes, including deficits in interactional skills, social cognition, pragmatics, and language. Social cognition includes 29 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

understanding and regulating our emotions as they affect others, and involved Theory of Mind. ToM is an evolving notion in children that others have a mind and emotions that differ from their own and that these must be considered in communication. Children with SCD exhibit inappropriate greetings, lack of flexibility in changing language and communication style for different settings or partners, difficulty producing and comprehending narratives, awkward engagement in all aspects of conversation, poor repair of communication breakdowns, inadequate/ineffective/confused verbal and nonverbal signals used to regulate conversational interaction, misinterpretation of the verbal and nonverbal signals of others, and/or difficulty understanding ambiguous or figurative language and information not explicitly stated.

76. Answers will vary, but should include some of the following points (see page 132, section titled “Language Target Selection and Sequence of Teaching”): The goal is the maximally effective use of language to accomplish communication goals within everyday interactions. Using the same assessment results, SLPs might differ in the targets they select. Decisions must be made about where to begin once the target is selected. The child‟s abilities are an important determinant of the method selected. Training should be within meaningful communication contexts when possible.

77. Answers will vary, but should include some of the following points (see pages 135– 136, section titled “Intervention Procedures”): Model the desired behavior. Cue the client to respond. Respond to the client in the form of reinforcement and/or corrective feedback. Plan for generalization of the learned feature to the everyday environment.

Article V. Chapter 5 Test Item File

Introduction to Communication Disorders 30 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

A Lifespan Evidence-Based Perspective

Seventh Edition

Dr. Robert E. Owens, College of St. Rose Dr. Kimberly A. Farinella, Northern Arizona University

Prepared by

Dr. Sarah A. Dachtyl

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Section 5.01

Table of Contents

Chapter 5: Speech Sound Disorders

1

Learning Objective Quizzes

1

Application Exercises

14

Test Items

17

Test Answer Key

22

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Section 5.02 Chapter 5: Speech Sound Disorders (a) Chapter 5 Learning Objective Quizzes Learning Objective 5.1: Explain how speech sounds (vowels and consonants) are classified.

[Q1] Consonants that have the same place and manner but differ in regard to voicing are referred to as: 1. cognate pairs. [correct] 2. voiced pairs.

3. stop consonants.

4. glottal.

[Feedback for Correct Answer 1] Consonants that have the same place and manner but differ in regard to voicing are referred to as cognate pairs.

[Feedback for Answer Choice 2] Consonants that have the same place and manner but differ in regard to voicing are referred to as cognate pairs. Voiced pairs is not an accepted term.

[Feedback for Answer Choice 3] Consonants that have the same place and manner but differ in regard to voicing are referred to as cognate pairs. Stop consonants are those in which there is complete closure of the vocal tract and airflow is completely blocked.

[Feedback for Answer Choice 4] Consonants that have the same place and manner but differ in regard to voicing are referred to as cognate pairs. Glottal sounds occur when the constriction occurs at the level of the vocal folds.

[Q2] are produced when the sound energy produced by the vibrating vocal folds is modified by the opened vocal tract.

1. Affricates 2. Vowels [correct] 3. Glottal 4. Nasals [Feedback for Answer Choice 1] 1 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Vowels are produced when the sound energy produced by the vibrating vocal folds is modified by the opened vocal tract. Affricates begin as stops and are released as fricatives.

[Feedback for Correct Answer 2] Vowels are produced when the sound energy produced by the vibrating vocal folds is modified by the opened vocal tract.

[Feedback for Answer Choice 3] Vowels are produced when the sound energy produced by the vibrating vocal folds is modified by the opened vocal tract. Glottal sounds occur when the constriction occurs at the level of the vocal folds.

[Feedback for Answer Choice 4] Vowels are produced when the sound energy produced by the vibrating vocal folds is modified by the opened vocal tract. Nasals are the only sounds produced with an open velopharyngeal port so that sound energy comes through the nose as opposed to the mouth.

[Q3] are produced when two vowels are said in close proximity.

1. Liquid vowels 2. Tense vowels 3. Lax vowels 4. Diphthongs [correct] [Feedback for Answer Choice 1] Diphthongs are produced when two vowels are said in close proximity. Liquid vowels is not an accepted term.

[Feedback for Answer Choice 2] Diphthongs are produced when two vowels are said in close proximity. Vowels can be classified by the amount of tension (tense, lax).

[Feedback for Answer Choice 3] Diphthongs are produced when two vowels are said in close proximity. Vowels can be classified by the amount of tension (tense, lax).

[Feedback for Correct Answer 4] Diphthongs are produced when two vowels are said in close proximity.

Learning Objective 5.2: Outline the sequence of speech sound acquisition across the lifespan.

[Q1] 2 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Axcel often omits final consonants, repeats syllables in multisyllabic words, and shortens consonant blends to single consonants. These are features that most closely align with: 1. infant speech.

2. toddler speech. [correct] 3. preschool speech.

4. school-age speech.

[Feedback for Answer Choice 1] Toddler speech is characterized by omission of final consonants, repetition of syllables in multisyllabic words, and shortening of consonant blends to single consonants. Infant speech patterns are less mature.

[Feedback for Correct Answer 2] Toddler speech is characterized by omission of final consonants, repetition of syllables in multisyllabic words, and shortening of consonant blends to single consonants.

[Feedback for Answer Choice 3] Toddler speech is characterized by omission of final consonants, repetition of syllables in multisyllabic words, and shortening of consonant blends to single consonants.

Preschool speech patterns are more mature.

[Feedback for Answer Choice 4] Toddler speech is characterized by omission of final consonants, repetition of syllables in multisyllabic words, and shortening of consonant blends to single consonants.

School-age speech features are more mature.

[Q2] William‟s phonological system is similar to an adult‟s. He has acquired most consonant clusters. These are features that most closely align with: 1. infant speech.

2. toddler speech.

3. preschool speech.

4. school-age speech. [correct] [Feedback for Answer Choice 1] School-age speech is characterized by a phonological system that is similar to an adult‟s. Most or all consonant clusters are acquired. Infant speech is less mature.

[Feedback for Answer Choice 2] School-age speech is characterized by a phonological system that is similar to an adult‟s. Most or all consonant clusters are acquired. Toddler speech is less mature.

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[Feedback for Answer Choice 3] School-age speech is characterized by a phonological system that is similar to an adult‟s. Most or all consonant clusters are acquired. Preschool speech is less mature.

[Feedback for Correct Answer 4] School-age speech is characterized by a phonological system that is similar to an adult‟s. Most or all consonant clusters are acquired.

[Q3] Claire no longer uses many phonological patterns, although she is still developing consonant blends. Sometimes she will produce a sound correctly in words but not in connected speech. These are features that most closely align with: 1. infant speech.

2. toddler speech.

3. preschool speech. [correct] 4. school-age speech.

[Feedback for Answer Choice 1] Preschool speech is characterized by use of some phonological patterns. Consonant blends are still developing. Sounds may be correctly produced in words but not in connected speech. Other features may be present. Infant speech is less mature.

[Feedback for Answer Choice 2] Preschool speech is characterized by use of some phonological patterns. Consonant blends are still developing. Sounds may be correctly produced in words but not in connected speech. Other features may be present. Toddler speech is less mature.

[Feedback for Correct Answer 3] Preschool speech is characterized by use of some phonological patterns. Consonant blends are still developing. Sounds may be correctly produced in words but not in connected speech. Other features may be present.

[Feedback for Answer Choice 4] Preschool speech is characterized by use of some phonological patterns. Consonant blends are still developing. Sounds may be correctly produced in words but not in connected speech. Other features may be present. School-age speech is more mature.

Learning Objective 5.3: Discuss the types of speech sound disorders in children.

[Q1] Declan often deletes phonemes when speaking. This is called: 1. omission. [correct] 2. substitution.

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3. distortion.

4. addition.

[Feedback for Correct Answer 1] Deletion of phonemes is called omission.

[Feedback for Answer Choice 2] Deletion of phonemes is called omission. Substitution refers to when one phoneme is replaced with another.

[Feedback for Answer Choice 3] Deletion of phonemes is called omission. Distortions occur when a nonstandard form of a phoneme is used.

[Feedback for Answer Choice 4] Deletion of phonemes is called omission. Additions occur when sounds are added to a word.

[Q2] Which of the following phoneme errors is most likely to persist into adulthood?

1. Substitution of /m/ 2. Distortion of /f/ 3. Distortion of /r/ [correct] 4. Substitution of /v/ [Feedback for Answer Choice 1] Errors can persist into adulthood and usually involve substitution or distortion of /r/, /s/, /z/, or /l/. A persistent substitution of /m/ would be rare.

[Feedback for Answer Choice 2] Errors can persist into adulthood and usually involve substitution or distortion of /r/, /s/, /z/, or /l/. A persistent distortion of /f/ would be rare.

[Feedback for Correct Answer 3] Errors can persist into adulthood and usually involve substitution or distortion of /r/, /s/, /z/, or /l/.

[Feedback for Answer Choice 4] Errors can persist into adulthood and usually involve substitution or distortion of /r/, /s/, /z/, or /l/. A persistent substitution of /v/ would be rare.

[Q3] Which of the following words ends in a closed syllable?

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1. Hay 2. Pillow 3. Basket [correct] 4. Tee [Feedback for Answer Choice 1] Closed syllables end in a consonant. Open syllables end in a vowel. This word ends in a vowel.

[Feedback for Answer Choice 2] Closed syllables end in a consonant. Open syllables end in a vowel. This word ends in a vowel.

[Feedback for Correct Answer 3] Closed syllables end in a consonant. Open syllables end in a vowel.

[Feedback for Answer Choice 4] Closed syllables end in a consonant. Open syllables end in a vowel. This word ends in a vowel.

Learning Objective 5.4: List the risk factors associated with speech sound disorders in children.

[Q1] Which of the following children is most likely to exhibit a speech sound delay?

1. Brody, a 3-year-old boy whose father had difficulty with /s/ production and whose mother was unable to continue school past 10th grade [correct] 2. Ryan, a 3-year-old boy whose parents did not exhibit speech or language difficulties and who graduated with their master‟s degrees 3. Chloe, a 3-year-old girl whose father had difficulty with /r/ production and whose parents both attended college 4. Milana, a 3-year-old girl whose parents did not exhibit speech or language difficulties and whose father did not graduate high school and whose mother earned her associate‟s degree [Feedback for Correct Answer 1] Speech sound delay tends to be more common in preschool-aged boys, as well as in those with family history of speech-language delay and low maternal education.

[Feedback for Answer Choice 2] Speech sound delay tends to be more common in preschool-aged boys, as well as in those with family history of speech-language delay and low maternal education. Ryan 6 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

does not have a family history of speech-language delay and his parents were highly educated.

[Feedback for Answer Choice 3] Speech sound delay tends to be more common in preschool-aged boys, as well as in those with family history of speech-language delay and low maternal education. Chloe is female and her parents are both highly educated.

[Feedback for Answer Choice 4] Speech sound delay tends to be more common in preschool-aged boys, as well as in those with family history of speech-language delay and low maternal education. Milana is female and does not have a family history of speech-language delay.

[Q2] Ju-won was born with a cleft palate. What percentage of preschoolers with repaired cleft palates and who receive early intervention from a qualified team achieve correct articulation?

1. 10% 2. 25% [correct] 3. 45% 4. 70% [Feedback for Answer Choice 1] Correct articulation can be expected in about 25% of preschoolers with repaired cleft palate who receive care early on from a qualified team of professionals. Ten percent is too low.

[Feedback for Correct Answer 2] Correct articulation can be expected in about 25% of preschoolers with repaired cleft palate who receive care early on from a qualified team of professionals.

[Feedback for Answer Choice 3] Correct articulation can be expected in about 25% of preschoolers with repaired cleft palate who receive care early on from a qualified team of professionals. Forty-five percent is too high.

[Feedback for Answer Choice 4] Correct articulation can be expected in about 25% of preschoolers with repaired cleft palate who receive care early on from a qualified team of professionals. Seventy percent is too high.

[Q3] Naomi is a 10-year-old girl who has cerebral palsy. Which of the following deficits are most likely to occur in those with cerebral palsy?

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1. High blood pressure 2. Childhood apraxia of speech 3. Epilepsy [correct] 4. Dyslexia [Feedback for Answer Choice 1] Accompanying deficits for those with cerebral palsy include epilepsy, visual processing deficits, and/or hearing impairment. High blood pressure is not included.

[Feedback for Answer Choice 2] Accompanying deficits for those with cerebral palsy include epilepsy, visual processing deficits, and/or hearing impairment. Childhood apraxia of speech is not included.

[Feedback for Correct Answer 3] Accompanying deficits for those with cerebral palsy include epilepsy, visual processing deficits, and/or hearing impairment.

[Feedback for Answer Choice 4] Accompanying deficits for those with cerebral palsy include epilepsy, visual processing deficits, and/or hearing impairment. Dyslexia is not included.

[Q4] Julia, a speech-language pathologist (SLP), ensures that she implements evaluation procedures that enable her to differentiate between disordered speech production and speech differences due to foreign language influences. Which of the following does she implement?

1. Reliance on standardized articulation measures 2. Interpretation of test data without case history information, which can complicate results 3. English-only speech-sound testing as that is the language of instruction 4. A test-teach-retest format [correct] [Feedback for Answer Choice 1] SLPs must differentiate between disordered speech production and that which is simply different due to foreign language or dialect influences. One method is to use dynamic assessments, which involves systematic assessment of stimulability of sounds in a testteach-retest format. Reliance on standardized articulation measures would not be considered effective.

[Feedback for Answer Choice 2] SLPs must differentiate between disordered speech production and that which is simply different due to foreign language or dialect influences. One method is to use dynamic assessments, which involves systematic assessment of stimulability of sounds in a test8 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

teach-retest format. A thorough and culturally sensitive case history would be important for this scenario.

[Feedback for Answer Choice 3] SLPs must differentiate between disordered speech production and that which is simply different due to foreign language or dialect influences. One method is to use dynamic assessments, which involves systematic assessment of stimulability of sounds in a testteach-retest format. SLPs should evaluate speech sound production competence in all relevant languages whenever possible.

[Feedback for Correct Answer 4] SLPs must differentiate between disordered speech production and that which is simply different due to foreign language or dialect influences. One method is to use dynamic assessments, which involves systematic assessment of stimulability of sounds in a testteach-retest format.

Learning Objective 5.5: Describe the goals and procedures in speech sound assessment.

[Q1] When an SLP uses a speech sample to determine if the child produces a particular sound at least two times, whether in the correct context, and organizes these sounds by place and manner of instruction, this is called a(n): 1. error analysis.

2. speech sound inventory. [correct] 3. intelligibility measure.

4. measure of percent consonants correct.

[Feedback for Answer Choice 1] In a speech sound inventory, SLPs determine if the child produced a particular sound at least two times, whether in the correct context or not, and organize the inventory by place and manner of production. In an error analysis, the SLP will report errors as either substitutions, omissions, distortions, or additions.

[Feedback for Correct Answer 2] In a speech sound inventory, SLPs determine if the child produced a particular sound at least two times, whether in the correct context or not, and organize the inventory by place and manner of production.

[Feedback for Answer Choice 3] In a speech sound inventory, SLPs determine if the child produced a particular sound at least two times, whether in the correct context or not, and organize the inventory by place and manner of production. Speech intelligibility refers to how easy it is to understand an individual.

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[Feedback for Answer Choice 4] In a speech sound inventory, SLPs determine if the child produced a particular sound at least two times, whether in the correct context or not, and organize the inventory by place and manner of production. In percent consonants correct, the SLP counts the number of opportunities for consonant production and then counts the total number of consonants the child produced relative to the adult target.

[Q2] Yonah demonstrates a high number of errors, so during his evaluation his SLP was sure to: 1. determine the type and frequency of phonological error patterns. [correct] 2. consult with an interpreter.

3. focus only on early-developing sounds.

4. allow Yonah to rely on gesture so he did not become frustrated by speaking.

[Feedback for Correct Answer 1] If a child has numerous errors, it is helpful to determine the type and frequency of phonological error patterns.

[Feedback for Answer Choice 2] If a child has numerous errors, it is helpful to determine the type and frequency of phonological error patterns. Consulting with an interpreter is helpful when there is a foreign language influence, but this is not named as a factor in this scenario.

[Feedback for Answer Choice 3] If a child has numerous errors, it is helpful to determine the type and frequency of phonological error patterns. Focusing only on early-developing sounds would not allow a comprehensive evaluation.

[Feedback for Answer Choice 4] If a child has numerous errors, it is helpful to determine the type and frequency of phonological error patterns. Allowing Yonah to rely on use of gesture would not allow for a comprehensive evaluation of Yonah‟s speech skills.

[Q3] Emalee was judged to be 80% intelligible by age 11. This is not typical. Why not?

1. Children should be 100% intelligible by age 3 2. Children should be 100% intelligible by age 5 [correct] 3. Children should be 100% intelligible by age 7 4. Children should be 100% intelligible by age 9 [Feedback for Answer Choice 1] 10 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Children should be intelligible 100% of the time by age 5 regardless of the language or languages spoken. Age 3 is too early.

[Feedback for Correct Answer 2] Children should be intelligible 100% of the time by age 5 regardless of the language or languages spoken.

[Feedback for Answer Choice 3] Children should be intelligible 100% of the time by age 5 regardless of the language or languages spoken. Age 7 would be considered late.

[Feedback for Answer Choice 4] Children should be intelligible 100% of the time by age 5 regardless of the language or languages spoken. Age 9 would be considered too late.

Learning Objective 5.6: Describe approaches and techniques to treat speech sound disorders, including supportive evidence.

[Q1] Paula mastered production of /s/ in all positions during speech therapy. The next step in her treatment would likely be: 1. immediate dismissal from speech therapy.

2. oral motor exercises for maintenance.

3. auditory discrimination for maintenance.

4. speech assignments to promote generalization outside the therapy setting. [correct] [Feedback for Answer Choice 1] When a sound is mastered in the therapy setting, speech assignments are provided to allow the client daily practice with their new skills and promote generalization outside the therapy setting. Immediate dismissal from speech therapy would likely not be indicated.

[Feedback for Answer Choice 2] When a sound is mastered in the therapy setting, speech assignments are provided to allow the client daily practice with their new skills and promote generalization outside the therapy setting. No evidence supports the use of oral motor exercises, so these are not recommended.

[Feedback for Answer Choice 3] When a sound is mastered in the therapy setting, speech assignments are provided to allow the client daily practice with their new skills and promote generalization outside the therapy setting. The utility of auditory discrimination training is also not well established and more research is needed.

[Feedback for Correct Answer 4] 11 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

When a sound is mastered in the therapy setting, speech assignments are provided to allow the client daily practice with their new skills and promote generalization outside the therapy setting.

[Q2] When selecting targets for speech therapy, what is one way to allow the child to increase communicative participation more quickly and effectively?

1. Select sound or word targets for immediate use in social contexts [correct] 2. Conduct therapy in the natural environment only.

3. Focus on sounds that are not stimulable.

4. Focus on sounds that are phonetically complex.

[Feedback for Correct Answer 1] Selecting sound or word targets for immediate use in social contexts will allow the child to increase communicative participation more quickly and effectively.

[Feedback for Answer Choice 2] Selecting sound or word targets for immediate use in social contexts will allow the child to increase communicative participation more quickly and effectively. The environment is not listed as a consideration for target selection, although it is an important therapeutic consideration.

[Feedback for Answer Choice 3] Selecting sound or word targets for immediate use in social contexts will allow the child to increase communicative participation more quickly and effectively. Focusing on sounds that are not stimulable would not lead to quick progress.

[Feedback for Answer Choice 4] Selecting sound or word targets for immediate use in social contexts will allow the child to increase communicative participation more quickly and effectively. Focusing on phonetically complex sounds can result in greater generalization to untreated sounds.

[Q3] What is a recommendation that is relevant to selecting treatment targets for bilingual children with speech sound disorders?

1. Use a motor-based approach because phonological approaches are not effective for bilingual children.

2. Use oral motor exercises because language factors will have less impact.

3. Choose phonological error patterns exhibited in the language of instruction.

4. Choose phonological error patterns exhibited in all languages spoken by the child. [correct] [Feedback for Answer Choice 1] 12 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

When selecting treatment targets for bilingual children with SSDs, it is recommended that the SLP choose phonological error patterns exhibited in both languages spoken by the child, specifically the ones that affect intelligibility greatly in both languages.

Phonological approaches are effective for bilingual children.

[Feedback for Answer Choice 2] When selecting treatment targets for bilingual children with SSDs, it is recommended that the SLP choose phonological error patterns exhibited in both languages spoken by the child, specifically the ones that affect intelligibility greatly in both languages. Oral motor exercises are not recommended.

[Feedback for Answer Choice 3] When selecting treatment targets for bilingual children with SSDs, it is recommended that the SLP choose phonological error patterns exhibited in both languages spoken by the child, specifically the ones that affect intelligibility greatly in both languages.

[Feedback for Correct Answer 4] When selecting treatment targets for bilingual children with SSDs, it is recommended that the SLP choose phonological error patterns exhibited in both languages spoken by the child, specifically the ones that affect intelligibility greatly in both languages.

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(b) Chapter 5 Application Exercises Application Exercise 5.1: Speech sound errors in children Learning Objective 5.3: Discuss the types of speech sound disorders in children.

Reference: Case Study: Daniel (see page 148) [Q1] Use Case Study: Daniel (page 148) to answer the following question: In this case study, what types of speech sound errors did Daniel demonstrate?

[Q1 Model Response] Final fricative deletion, substitution of /t/ for /k/ and /d/ for /g/, substitution of /t/ for “ch,” substitution of “y” for /l/ and /w/ for /r/. The Spanish trill was not observed. Clusters were reduced to singleton sounds. Three syllable words were reduced to two syllables.

[Q2] Use Case Study: Daniel (page 148) to answer the following question: In this case study, how did Daniel‟s speech sound errors impact his intelligibility?

[Q2 Model Response] Daniel‟s parents indicated on the Intelligibility in Context Scale that Daniel is sometimes intelligible regardless of whether he is speaking Spanish or English.

[Q3] Use Case Study: Daniel (page 148) to answer the following question: What is stimulability testing for speech sound disorders and what did it reveal for Daniel?

[Q3 Model Response] Stimulability for producing target sounds is assessed via explicit teaching from the SLP. Daniel could correctly produce /k/ and /g/ sounds.

Application Exercise 5.2: Risk factors for speech sound disorders in children Learning Objective 5.4: List the risk factors associated with speech sound disorders in children.

Reference: Figure 5.4 and Case Study: Daniel (see page 153) [Q1] Use Figure 5.4 and Case Study: Daniel (see page 153) to answer the following question: In this case study, which two risk factors for a speech sound disorder did Daniel have?

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[Q1 Model Response] Daniel‟s risk factors for a speech sound disorder included being male and having a family history of speech production difficulties.

[Q2] Use Figure 5.4 and Case Study: Daniel (see page 153) to answer the following question: In this case study, what are two risk factors for speech sound disorder that were ruled out for Daniel?

[Q2 Model Response] Structural functional abnormalities and hearing loss were ruled out for Daniel.

Application Exercise 5.3: Treatment approaches for speech sound disorders Learning Objective 5.6: Describe approaches and techniques to treat speech sound disorders, including supportive evidence.

Reference: Box 5.1 (page 167) and Case Study: Daniel (pages 164 and 166) [Q1] Use Box 5.1 (page 167) and Case Study: Daniel (pages 164 and 166) to answer the following question: Name and briefly describe the four phonological-based treatment approaches.

[Q1 Model Response] Minimal pair contrasts: The contrasting of phonemes in pairs of words, such as pig-big.

Cycles approach: Targets multiple phonological patterns over an extended period of time. Multiple oppositions approach: Contrasts several target sounds with a comparison sound, with is effective for children who substitute one sound for multiple sounds.

Complexity approach: Targeting later-acquired sounds and/or consonant clusters leads to increases in treated and untreated sounds, both within and across sound classes.

[Q2] Use Box 5.1 (page 167) and Case Study: Daniel (pages 164 and 166) to answer the following question: Name and briefly describe the three motor-based treatment approaches.

[Q2 Model Response] Traditional motor and sensory motor approaches: Effective for children with only one or a few sounds in error and who have language skills that are within normal limits.

Dynamic temporal and tactile cueing: Intensive treatment effective for children with severe childhood apraxia of speech. Lee Silverman Voice Treatment: Effective in young children with spastic cerebral palsy in loudness and speech intelligibility.

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[Q3] Use Box 5.1 (page 167) and Case Study: Daniel (pages 164 and 166) to answer the following question: Given the cast study for Daniel and his specific phonological error patterns in Spanish and English, what might his treatment progression be?

[Q3 Model Response] Treatment goals to reduce the occurrence of velar fronting, stopping, weak syllable deletion, and consonant cluster reduction might be best initially. Later-developing sounds might be addressed later in treatment to maximize success and minimize frustration. Because Daniel was stimulable for /k/ and /g/, these sounds should come along more readily once treatment begins. Functionally relevant words in Spanish and English should be targeted.

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(c) Chapter 5 Test Items 1.

specify acceptable sequences and locations of speech sounds. a. Distinctive features b. Phonotactic rules c. Morphemes d. Phonological classes

2.

is when two vowels are said in close proximity. a. A glide b. A liquid c. A diphthong d. An approximate

3. By

, infants are able to imitate tone and pitch and begin babbling.

a. 2 months b. 3 months c. 4–6 months d. 7–8 months 4. At 6–7 months, babbling changes into

.

a. single words b. variegated babbling c. reduplicated babbling d. bilabial fricatives 5. Young children use

to simplify a difficult word.

a. echolalia b. phonological patterns c. articulatory errors d. sound-meaning relationships 6. Most of the phonological patterns that toddlers use disappear by age a. 3. b. 4. c. 6. d. 7.

7. Children who experience phonological difficulties 17 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

a. discontinue the use of immature phonological patterns earlier than their peers. b. are always unintelligible. c. continue the use of immature phonological patterns. d. express more interest in literacy activities.

8.

is/are long strings of syllables with adult-like intonation. a. Jargon b. Neologisms c. Approximations d. Substitutions

9. By age

, children have acquired consonant clusters.

a. 5 b. 6 c. 7 d. 8 10.

are disorders of how speech sounds are used in the language. a. Phonological impairments b. Articulation disorders c. Voice disorders d. Resonance disorders

11. Seventy-five percent of children normalize their speech sound errors by age with or without treatment. a. 5 b. 6 c. 8 d. 10 12. Speech talk.

over time for those who lose their hearing after learning to

a. maintains b. deteriorates c. improves d. exacerbates 13. About 90% of children with impairment.

have some form of motor speech

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a. cerebral palsy b. deafness c. childhood apraxia of speech d. cleft lip 14.

is a neurological speech sound disorder that affects the ability to plan and/or program the movement sequences necessary for accurate speech production. a. Cerebral palsy b. Childhood apraxia of speech c. Language impairment d. Aphasia

15. The most readily apparent difficulties are with motor programming difficulties.

for those who persist

a. in monosyllabic words b. substitution errors c. in consonant blends d. prosodic abnormalities 16.

is the ability to produce the target phoneme when given focused auditory and visual cues. a. Consistency b. Focused stimulation c. Stimulability d. Echolalia

17.

tasks are the most efficient way to collect data about the use of phonemes across word positions in a language, as well as word shapes and prosody. a. Discourse b. Narrative c. Single-word d. Isolated phoneme

18. Targeting a/an has the advantage of encouraging generalization of learning to similar sounds and phonological contexts. a. prosodic contour b. narrative c. individual sound 19 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

d. error pattern 19. In general, highly unintelligble speech signals

.

a. a more severe SSD b. complex CV patterns c. a high PCC d. exclusively omission errors 20. Some research studies have demonstrated that greater generalization to untreated sounds occurs when the sound targets are . a. simpler b. more difficult c. stimulable d. less phonetically complex 21.

are not recommended as there is no evidence that supports their use. a. Oral-motor exercises b. Motor-based treatment approaches c. Phonological-based treatment approaches d. Self-monitoring exercises

22. Introducing from the beginning of therapy can help clients understand that they are ultimately responsible for their own success. a. phonological-based treatment approaches b. auditory discrimination training c. oral motor exercises d. self-monitoring exercises 23. How are consonant phonemes classified?

24. Name the places of articulation.

25. Name the manners of articulation.

26. What determines which vowel is actually produced?

27. What types of speech errors do toddlers commonly make?

28. A/an consonant.

ends in a vowel, whereas a

ends in a

29. Name the four types of articulation errors.

30. Which three types of sounds are easier to produce and acquired early?

31. Name three types of sounds that are often difficult for children with cleft palate to 20 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

produce.

32. What are the speech characteristics of childhood apraxia of speech?

33. What are two good prognostic indicators for verbal communiction in C AS? 34. What is the overall goal of elective therapy for accent modification?

35. Name three risk factors for speech sound delay in early childhood.

36.

refers to how easy it is to understand the individual.

37. What are three common omission error patterns in individuals who are deaf?

38. What are three factors that the case history should include when developing a comprehensive language profile for multilingual children?

39. How does stimulability inform improvement with and without therapy?

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(d) Chapter 5 Test Answer Key 1. B (see page 143, section titled “Understanding Speech Sounds”) 2. C (see page 145, section titled “Classification of Vowels by Tongue and lip Position and Tension”) 3. C (see page 145, section titled “Speech Sound Emergence”) 4. C (see page 146, section titled “Speech Sound Emergence”) 5. B (see page 147, section titled “Toddler Speech”) 6. B (see page 148, section titled “Preschool Speech”) 7. C (see page 148, section titled “Preschool Speech”) 8. A (see page 147, section titled “Speech Sound Emergence”) 9. D (see page 150, section titled “School-Age Speech”) 10. A (see page 151, section titled “Types of Speech Sound Disorders in Children”) 11. B (see page 152, section titled “Lifespan Issues”) 12. B (see page 154, section titled “Lifespan Issues”) 13. A (see page 155, section titled “Dysarthria”) 14. B (see page 156, section titled “Childhood Apraxia of Speech”) 15. D (see page 157, section titled “Lifespan Issues”) 16. C (see page 165, section titled “Stimulability”) 17. C (see page 161, section titled “Description of the Speech Sound System”) 18. D (see page 168, section titled “Phonological-Based Treatment Approaches”) 19. A (see page 165, section titled “Intelligibility”) 20. B (see page 166, section titled “Target Selection”) 21. A (see page 168, section titled “Motor-Based Treatment Approaches”) 22. D (see pages 168–169, section titled “Generalization and Maintenance”) 23. Answers should include the following information (see page 143, section titled “Classification of Consonants by Place, Manner, and Voicing”): Place, manner, and voicing 24. Answers should include the following information (see pages 143–144, section titled “Classification of Consonants by Place, Manner, and Voicing”): Bilabial, labiodental, interdental, linguadental, alveolar, palatal, velar, glottal 25. Answers should include the following information (see page 144, section titled “Classification of Consonants by Place, Manner, and Voicing”): Stop consonants, fricatives, affricates, nasals, glides, and liquids.

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26. Answers should include the following information (see page 144, section titled “Classification of Vowels by Tongue and Lip Position and Tension”): Which part of the tongue is elevated (front, center, back), its height (high, mid, low), and the amount of tension (tense, lax). Lip rounding or retraction can influence the sound.

27. Answers should include the following information (see pages 147–148, section titled “Toddler Speech”): Omission of final consonants, syllables or consonants in multisyllabic words might be repeated, consonant blends might be shortened to single consonants, sound substitutions.

28. Answers should include the following information (see page 151, section titled “Types of Speech Sound Disorders in Children”): Open syllable; closed syllable 29. Answers should include the following information (see page 151, section titled “Types of Speech Sound Disorders in Children”): Substitutions, omissions, distortions, additions 30. Answers will vary but should include some of the following points (see page 149, section titled “Preschool Speech”): Stops, nasals, and glides are usually first.

31. Answers will vary but should include some of the following points (see page 155, section titled “Lifespan Issues”): High-pressure consonants, fricatives, and affricates 32. Answers will vary but should include some of the following points (see pages 156– 157, section titled “Childhood Apraxia of Speech”): Speech is often unintelligible, segmented/choppy, disfluent, or lacking in prosodic variation. Children may be aware that speech is difficult and are often unwilling to try to talk. May have inconsistent errors on consonants and vowels in repeated productions, lengthened and disrupted transitions between sounds and syllables, and inappropriate prosody. May have limited consonant and vowel repertoires, exhibit groping or trial and error behaviors, omit or inappropriately add sounds, and have difficulty with running speech. May have concomitant expressive language and phonological impairments.

33. Answers will vary but should include some of the following points (see page 157, section titled “Lifespan Issues”): Average intellectual and receptive language abilities, good receptive language.

34. Answers will vary but should include some of the following points (see page 159, section titled “Lifespan Issues”): Improve intelligibilty and communicative effectiveness. Articulatory patterns of a first language may be firmly established and difficult to eliminate.

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35. Answers will vary but should include some of the following points (see pages 152– 153, section titled “Male Sex”): Male sex, family history of speech/language delay, low maternal education.

36. Answers should include the following (see page 165, section titled “Intelligibility”): Speech intelligibility 37. Answers will vary but should include some of the following points (see page 154, section titled “Hearing Status/Hearing Loss”): Final consonant deletion, initial consonant deletion, deletion of /s/ in all contexts.

38. Answers will vary but should include some of the following points (see page 161, section titled “Case History”): Age at which the child was exposed to each language, the amount of exposure and use of each language each day of the week, and the individuals who speak each language with the child.

39. Answers will vary but should include some of the following points (see page 165, section titled “Stimulability”): Children who are stimulable may respond more quickly to correction of the target sounds and may also be more likely to self-correct without therapy than those who are not stimulable. Those sounds for which a child is not stimulable are highly unlikely to change without treatment. Among children in therapy, those with low stimulability scores often make more progress, especially with untreated sounds, than do those who are more stimulable.

Article VI. Chapter 6 Test Item File

Introduction to Communication Disorders A Lifespan Evidence-Based Perspective 24 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Seventh Edition

Dr. Robert E. Owens, College of St. Rose Dr. Kimberly A. Farinella, Northern Arizona University

Prepared by

Dr. Sarah A. Dachtyl

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Section 6.01

Table of Contents

Chapter 6: Developmental Literacy Disorders

1

Learning Objective Quizzes

1

Application Exercises

13

Test Items

16

Test Answer Key

21

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Section 6.02 Chapter 6: Developmental Literacy Disorders (a) Chapter 6 Learning Objective Quizzes Learning Objective 6.1: Explain important aspects of reading and their development.

[Q1] Which of the following is strongly linked to poor reading comprehension?

1. Poor morphological awareness 2. Difficulty blending 3. Poor oral vocabulary knowledge [correct] 4. Difficulty segmenting words into sounds [Feedback for Answer Choice 1] Poor oral vocabulary knowledge is strongly linked to poor reading comprehension. Poor morphological awareness is not as strongly linked to reading comprehension.

[Feedback for Answer Choice 2] Poor oral vocabulary knowledge is strongly linked to poor reading comprehension.

Difficulty blending is not as strongly linked to reading comprehension.

[Feedback for Correct Answer 3] Poor oral vocabulary knowledge is strongly linked to poor reading comprehension.

[Feedback for Answer Choice 4] Poor oral vocabulary knowledge is strongly linked to poor reading comprehension.

Difficulty segmenting words into sounds is not strongly linked to reading comprehension.

[Q2] N‟ Golo is 8 years old and enjoys when his parents read to him. He will often pretend to read on his own. Which of the following can be inferred?

1. N‟ Golo has good language skills. [correct] 2. N‟ Golo has disordered decoding.

3. N‟ Golo is demonstrating early signs of a language disorder.

4. Incorporating literacy at this age is developmentally inappropriate.

[Feedback for Correct Answer 1] Children with good language seem to enjoy reading activities more than children with poor language and will pretend to read at an early age.

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[Feedback for Answer Choice 2] Children with good language seem to enjoy reading activities more than children with poor language and will pretend to read at an early age. There is no indication that he had disordered decoding.

[Feedback for Answer Choice 3] Children with good language seem to enjoy reading activities more than children with poor language and will pretend to read at an early age. There is no indication that he has a language disorder.

[Feedback for Answer Choice 4] Children with good language seem to enjoy reading activities more than children with poor language and will pretend to read at an early age. Incorporating literacy early on is important for development.

[Q3] is the ability to quickly name a series of items in a category, such as types of clothing or food.

1. Inferencing 2. Rapid automatized naming [correct] 3. Metacognition 4. Executive function [Feedback for Answer Choice 1] Rapid automatized naming (RAN) is the ability to quickly name a series of items in a category, such as types of clothes or food. Inferencing is the ability to understand a message in context where some elements are not explicitly known.

[Feedback for Correct Answer 2] Rapid automatized naming (RAN) is the ability to quickly name a series of items in a category, such as types of clothes or food.

[Feedback for Answer Choice 3] Rapid automatized naming (RAN) is the ability to quickly name a series of items in a category, such as types of clothes or food. Metacognition is knowing what to do and how to do it.

[Feedback for Answer Choice 4] Rapid automatized naming (RAN) is the ability to quickly name a series of items in a category, such as types of clothes or food. Executive function refers to self-regulation that includes the ability to attend; set reasonable goals; plan and organize to achieve goals; initiate, monitor, and evaluate performance in relation to goals; and revise plans and strategies based on feedback).

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Learning Objective 6.2: Characterize reading problems through the lifespan.

[Q1] Leigh has dyslexia. Which of the following is a positive characteristic often related to dyslexia as indicated in this chapter?

1. Those with dyslexia are gifted mathematically.

2. Those with dyslexia have superior visuospatial awareness.

3. Those with dyslexia have above-average pragmatic language skills as a group.

4. Those with dyslexia use more creative approaches and solutions. [correct] [Feedback for Answer Choice 1] In general, children and adults with dyslexia see the world differently, leading to more creative approaches and solutions. This chapter does not refer to mathematical ability.

[Feedback for Answer Choice 2] In general, children and adults with dyslexia see the world differently, leading to more creative approaches and solutions. This chapter does not refer to visuospatial awareness.

[Feedback for Answer Choice 3] In general, children and adults with dyslexia see the world differently, leading to more creative approaches and solutions. This chapter does not refer to pragmatic language skills.

[Feedback for Correct Answer 4] In general, children and adults with dyslexia see the world differently, leading to more creative approaches and solutions.

[Q2] Lanie is a 5-year-old girl who has above-average word recognition ability and is an avid reader. However, her reading comprehension is poor. This profile is most consistent with: 1. specific learning disorder in literacy.

2. hyperlexia. [correct] 3. dyslexia.

4. alexia.

[Feedback for Answer Choice 1] Children with hyperlexia have poor comprehension but typical to above-average word recognition ability. Children with a specific learning disorder in literacy (S LDL) have learning disorders primarily manifested in reading and writing.

[Feedback for Correct Answer 2] 3 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Children with hyperlexia have poor comprehension but typical to above-average word recognition ability.

[Feedback for Answer Choice 3] Children with hyperlexia have poor comprehension but typical to above-average word recognition ability. Children with SLDL or dyslexia have poor word recognition or decoding abilities, accompanied by problems with phonological processing.

[Feedback for Answer Choice 4] Children with hyperlexia have poor comprehension but typical to above-average word recognition ability. Alexia is not referred to in this chapter and is most typically related to a loss of reading ability in adults after a neurological event.

[Q3] Children with LD are substantially below typical readers by which grade?

1. Kindergarten 2. 1st grade 3. 3rd grade 4. 5th grade [correct] [Feedback for Answer Choice 1] Children with LD acquire reading skills more rapidly in the initial stages and then gradually slow; these children are substantially below typical readers by 5th grade.

Children may be behind in kindergarten, but as a group this difference is not considered substantial.

[Feedback for Answer Choice 2] Children with LD acquire reading skills more rapidly in the initial stages and then gradually slow; these children are substantially below typical readers by 5th grade.

Children may be behind in 1st grade, but as a group this difference is not yet considered substantial.

[Feedback for Answer Choice 3] Children with LD acquire reading skills more rapidly in the initial stages and then gradually slow; these children are substantially below typical readers by 5th grade.

Children may be behind in 3rd grade, but as a group this difference is not yet considered substantial.

[Feedback for Correct Answer 4] Children with LD acquire reading skills more rapidly in the initial stages and then gradually slow; these children are substantially below typical readers by 5th grade.

Learning Objective 6.3: Detail assessment and intervention for reading disorder.

[Q1] 4 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

When reading, the percentage of incorrect but linguistically acceptable words indicates: 1. the child‟s ability to self-monitor and self-correct.

2. that the child‟s comprehension is within normal limits.

3. that the child‟s vocabulary is above average.

4. the extent of a child‟s use of linguistic cues to predict the correct word. [correct] [Feedback for Answer Choice 1] The percentage of incorrect but linguistically acceptable words indicates the extent of a child‟s use of linguistic cues to predict the correct word. This is unrelated to selfmonitoring and self-correction skills.

[Feedback for Answer Choice 2] The percentage of incorrect but linguistically acceptable words indicates the extent of a child‟s use of linguistic cues to predict the correct word. This skill does not measure comprehension.

[Feedback for Answer Choice 3] The percentage of incorrect but linguistically acceptable words indicates the extent of a child‟s use of linguistic cues to predict the correct word. This skill does not measure vocabulary.

[Feedback for Correct Answer 4] The percentage of incorrect but linguistically acceptable words indicates the extent of a child‟s use of linguistic cues to predict the correct word.

[Q2] In a(n) , young children participate in literacy-rich experiences in the daily curriculum and in explicit therapeutic teaching of reading.

1. embedded/explicit model of intervention [correct] 2. postreading activity 3. distancing intervention 4. story framework treatment [Feedback for Correct Answer 1] An embedded/explicit model of intervention may be used in which younger children participate in both literacy-rich experiences in the daily curriculum and in explicit therapeutic teaching of reading.

[Feedback for Answer Choice 2] An embedded/explicit model of intervention may be used in which younger children participate in both literacy-rich experiences in the daily curriculum and in explicit therapeutic teaching of reading. Postreading activities are not an intervention; rather, 5 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

they are activities that can include use of story organizers, retelling, and creating narrative variations.

[Feedback for Answer Choice 3] An embedded/explicit model of intervention may be used in which younger children participate in both literacy-rich experiences in the daily curriculum and in explicit therapeutic teaching of reading. Distancing is not an intervention; rather, distancing from the text and toward independent thinking is an executive function important for more advanced readers.

[Feedback for Answer Choice 4] An embedded/explicit model of intervention may be used in which younger children participate in both literacy-rich experiences in the daily curriculum and in explicit therapeutic teaching of reading. Story frameworks are not an intervention; rather, there are a variety of frameworks for various types of storytelling.

[Q3] can be enhanced through emergent reading activities that focus on the words to be encountered and through use of visual or verbal memory aids.

1. Decoding skills 2. Literate vocabularies [correct] 3. Phonics skills 4. Phonological awareness [Feedback for Answer Choice 1] Literate vocabularies can be enhanced through emergent reading activities that focus on the words to be encountered and through use of visual or verbal memory aids.

Decoding would not be enhanced through these activities.

[Feedback for Correct Answer 2] Literate vocabularies can be enhanced through emergent reading activities that focus on the words to be encountered and through use of visual or verbal memory aids.

[Feedback for Answer Choice 3] Literate vocabularies can be enhanced through emergent reading activities that focus on the words to be encountered and through use of visual or verbal memory aids.

Phonics would not be enhanced through these activities.

[Feedback for Answer Choice 4] Literate vocabularies can be enhanced through emergent reading activities that focus on the words to be encountered and through use of visual or verbal memory aids.

Phonological awareness would not be enhanced by these activities.

Learning Objective 6.4: Explain important aspects of writing and their development.

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[Q1] Damian is a 12th grade student who falls below grade-level standards for writing. Which statistic correctly represents how common this is in the United States?

1. Only 7% of 8th and 12th graders in the United States meet grade-level standards.

2. Only 15% of 8th and 12th graders in the United States meet grade-level standards.

3. Only 27% of 8th and 12th graders in the United States meet grade-level standards. [correct] 4. Only 36% of 8th and 12th graders in the United States meet grade-level standards.

[Feedback for Answer Choice 1] In the United States, only 25% of 4th graders and 27% of 8th and 12th graders met grade-level writing expectations. Seven percent is not accurate.

[Feedback for Answer Choice 2] In the United States, only 25% of 4th graders and 27% of 8th and 12th graders met grade-level writing expectations. Fifteen percent is not accurate.

[Feedback for Correct Answer 3] In the United States, only 25% of 4th graders and 27% of 8th and 12th graders met grade-level writing expectations.

[Feedback for Answer Choice 4] In the United States, only 25% of 4th graders and 27% of 8th and 12th graders met grade-level writing expectations. Thirty-six percent is not accurate.

[Q2] As children become more aware of vocabulary, textual themes, and attitude.

, they alter syntax,

1. the audience [correct] 2. letter formation 3. sound–letter associations 4. sequencing [Feedback for Correct Answer 1] Children become more aware of the audience and alter syntax, vocabulary, textual themes, and attitude.

[Feedback for Answer Choice 2] Children become more aware of the audience and alter syntax, vocabulary, textual themes, and attitude. Letter formation is not a relevant factor.

[Feedback for Answer Choice 3] 7 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Children become more aware of the audience and alter syntax, vocabulary, textual themes, and attitude. Sound–letter associations is not a relevant factor.

[Feedback for Answer Choice 4] Children become more aware of the audience and alter syntax, vocabulary, textual themes, and attitude. Sequencing is not a relevant factor.

[Q3] By what grade should most students be capable of revising all aspects of writing?

1. By 2nd grade 2. By 3rd grade 3. By 4th grade 4. By 7th grade [correct] [Feedback for Answer Choice 1] By junior high school, teens are capable of revising all aspects of writing. Second grade is too early.

[Feedback for Answer Choice 2] By junior high school, teens are capable of revising all aspects of writing. Third grade is too early.

[Feedback for Answer Choice 3] By junior high school, teens are capable of revising all aspects of writing. Fourth grade is too early.

[Feedback for Correct Answer 4] By junior high school, teens are capable of revising all aspects of writing.

Learning Objective 6.5: Characterize writing problems through the lifespan.

[Q1] Deficits in spelling typically represent poor phonological processing and knowledge/use of .

1. grapheme-phoneme conversion 2. visual matching skills 3. writing complexity 4. phoneme-grapheme information [correct] [Feedback for Answer Choice 1]

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Usually, deficits in spelling represent poor phonological processing and knowledge/use of phoneme-grapheme information. Grapheme-phoneme conversion is relevant for reading as opposed to writing.

[Feedback for Answer Choice 2] Usually, deficits in spelling represent poor phonological processing and knowledge/use of phoneme-grapheme information. Visual matching skills are not relevant for this question.

[Feedback for Answer Choice 3] Usually, deficits in spelling represent poor phonological processing and knowledge/use of phoneme-grapheme information. Writing complexity is not relevant for this question.

[Feedback for Correct Answer 4] Usually, deficits in spelling represent poor phonological processing and knowledge/use of phoneme-grapheme information.

[Q2] Children with learning disorder (LD) have substantial difficulty using in writing, even when they are used correctly in speech.

1. phonemes 2. morphological endings [correct] 3. correct spelling 4. punctuation [Feedback for Answer Choice 1] Children with LD have substantial difficulty using morphological endings in writing, even when they can use these morphemes correctly in speech. Phonemes are not used in writing.

[Feedback for Correct Answer 2] Children with LD have substantial difficulty using morphological endings in writing, even when they can use these morphemes correctly in speech.

[Feedback for Answer Correct 3] Children with LD have substantial difficulty using morphological endings in writing, even when they can use these morphemes correctly in speech. Spelling is not used in speech.

[Feedback for Answer Choice 4] Children with LD have substantial difficulty using morphological endings in writing, even when they can use these morphemes correctly in speech. Punctuation is not used in speech.

[Q3] 9 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

What is an example of an omission of a morphological marker in spelling?

1. Omission of plural “s” [correct] 2. Omission of syllables 3. Omission of word roots 4. Omission of letters in consonant blends [Feedback for Correct Answer 1] Misspellings are characterized by omission of syllables, morphological markers such as plural “s.”

[Feedback for Answer Choice 2] Misspellings are characterized by omission of syllables, morphological markers such as plural “s.” Syllables are not equivalent to morphological markers.

[Feedback for Answer Choice 3] Misspellings are characterized by omission of syllables, morphological markers such as plural “s.” Word roots are not necessarily morphological markers.

[Feedback for Answer Choice 4] Misspellings are characterized by omission of syllables, morphological markers such as plural “s.” Letters within consonant blends are not morphological markers.

Learning Objective 6.6: Detail assessment and intervention for writing disorder.

[Q1] Writing can be analyzed on several levels for writing assessment: textual, linguistic, and .

1. phonological 2. clausal density 3. orthographic [correct] 4. morphological [Feedback for Answer Choice 1] Writing can be analyzed on several levels: textual, linguistic, and orthographic.

[Feedback for Answer Choice 2] Writing can be analyzed on several levels: textual, linguistic, and orthographic.

[Feedback for Correct Answer 3] Writing can be analyzed on several levels: textual, linguistic, and orthographic.

[Feedback for Answer Choice 4] Writing can be analyzed on several levels: textual, linguistic, and orthographic.

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[Q2] Word prediction programs reduce spelling errors of children with language disorders by approximately what percentage?

1. Over 50% [correct] 2. Over 70% 3. Over 80% 4. 100% [Feedback for Correct Answer 1] Word prediction programs reduce spelling errors of children with language disorders by over half.

[Feedback for Answer Choice 2] Word prediction programs reduce spelling errors of children with language disorders by over half. Seventy percent is too high.

[Feedback for Answer Choice 3] Word prediction programs reduce spelling errors of children with language disorders by over half. Eighty percent is too high.

[Feedback for Answer Choice 4] Word prediction programs reduce spelling errors of children with language disorders by over half. One hundred percent is too high.

[Q3] In order to increase Christian‟s motivation to write at school, what effective method does his teacher employ?

1. She focuses on proofreading methods.

2. She allows Christian to select his own topic. [correct] 3. She facilitates Christian‟s use of pre-writing activities.

4. She focuses on improving Christian‟s use of word prediction.

[Feedback for Answer Choice 1] Allowing children to select their own topic can increase motivation and shift the focus to ideas. Proofreading instruction is not included as a way to increase motivation to write.

[Feedback for Correct Answer 2] Allowing children to select their own topic can increase motivation and shift the focus to ideas.

[Feedback for Answer Choice 3]

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Allowing children to select their own topic can increase motivation and shift the focus to ideas. Use of pre-writing activities is not included as a way to increase motivation to write.

[Feedback for Answer Choice 4] Allowing children to select their own topic can increase motivation and shift the focus to ideas. Improving use of word prediction is not included as a way to increase motivation to write.

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(b) Chapter 6 Application Exercises Application Exercise 6.1: Describing personal experiences with dyslexia Learning Objective 6.2: Characterize reading problems through the lifespan.

Reference: Pearson eText Video Example 6.5 [Q1] Use Pearson eText Video Example 6.5 to answer the following question: How did Kathy describe what it is like to have dyslexia?

[Q1 Model Response] She stated that she couldn‟t make any sense of what she read and agreed with the reporter‟s query as to whether it would be like a monolingual English speaker attempting to read Arabic.

[Q2] Use Pearson eText Video Example 6.5 to answer the following question: How do the clinical experts in the video define dyslexia?

[Q2 Model Response] Dyslexia is an unexpected difficulty in reading in an individual who has the intelligence to read at a much higher level.

[Q3] Use Pearson eText Video Example 6.5 to answer the following question: What are two important findings from the experts‟ longitudinal research in dyslexia?

[Q3 Model Response] Two important findings from the research include that one in five individuals may have dyslexia and that dyslexia is not related to intelligence.

[Q4] Use Pearson eText Video Example 6.5 to answer the following question: What did Laura Cassidy do to provide support for her daughter, who was diagnosed with dyslexia? What did efforts did she undertake later on for other children diagnosed with dyslexia?

[Q4 Model Response] Laura Cassidy hired a private tutor to help her daughter. She later opened the Louisiana Key Academy, a public school for children diagnosed with dyslexia. Instruction is focused on early instruction in reading-specific activities, such as decoding.

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[Q5] Use Pearson eText Video Example 6.5 to answer the following question: What are the potential negative effects of dyslexia on an individual as described in this video?

[Q5 Model Response] There is a decreased likelihood of graduating from high school, being accepted into college, and graduating from college. There is also a higher number (50%) of prison inmates who have a diagnosis of dyslexia.

Application Exercise 6.2: Evidence-based practice for reading Learning Objective 6.3: Detail assessment and intervention for reading disorder.

Reference: Box 6.1 (page 194) [Q1] Use Box 6.1 (page 194) to answer the following question: Based on the evidence-based practice for reading information in Box 6.1, what are the best strategies for improving reading comprehension in children with LD? [Q1 Model Response] Auditory/language strategies have a greater impact on the reading comprehension of children with LD than visual strategies, demonstrating the underlying spoken-written language link.

[Q2] Use Box 6.1 (page 194) to answer the following question: Based on the evidence-based practice for reading information in Box 6.1, what techniques designed to improve phonological awareness in children are effective?

[Q2 Model Response] Tasks designed to improve rhyming, sound identification, phoneme segmentation, phoneme manipulation, and grapheme-phoneme correspondence consistently yield moderately large to large effects. Similar effects can be obtained through classroom collaboration and clinician-only approaches.

[Q3] Use Box 6.1 (page 194) to answer the following question: Based on the evidence-based practice for reading information in Box 6.1, which phonological skills are critical for reading?

[Q3 Model Response] 14 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Segmenting and blending are critical skills needed for reading. Lower-level skills are important to the extent that they facilitate subsequent development of segmenting and blending.

Application Exercise 6.3: Evidence-based practice for writing Learning Objective 6.6: Detail assessment and intervention for writing disorder.

Reference: Box 6.2 (see page 207) [Q1] Use Box 6.2 (see page 207) to answer the following question: Based on the evidence-based practice for writing information in Box 6.2, how can literacy development be best supported for English learners?

[Q1 Model Response] Self-regulation strategies, including explicit instruction, self-review, and peer modeling, show promise. Literacy instruction in Spanish while children continue to learn English supports English learners‟ literacy development in English.

[Q2] Use Box 6.2 (see page 207) to answer the following question: Based on the evidence-based practice for writing information in Box 6.2, what types of studying strategies for spelling words and self-monitoring are effective?

[Q2 Model Response] Word sorting, word hunts, flashcards, and peer practice with spelling words are effective.

[Q3] Use Box 6.2 (see page 207) to answer the following question: Based on the evidence-based practice for writing information in Box 6.2, what do questioning strategies involve for writing instruction?

[Q3 Model Response] Questioning strategies involve self-instruction (executive function), paragraph restatements, and strategies that focus on the text structure.

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(c) Chapter 6 Test Items 1.

is the use of visual modes of communication, specifically reading and writing. a. Literacy b. Composition c. Decoding d. Phonological awareness

2. Decoding is a. knowledge of sounds/syllables and the sound structure of words. b. segmenting a word and blending the sounds together to form a word. c. the ability to manipulate sounds. d. active analysis and synthesis of information.

3. Sound-letter correspondence is called a. RAN. b. phonics. c. reading. d. decoding.

4. Phonological awareness is a. knowledge of sounds/syllables and the sound structure of words. b. segmenting a word and blending the sounds together to form a word. c. the ability to manipulate sounds. d. active analysis and synthesis of information.

5. Phonemic awareness is a. knowledge of sounds/syllables and the sound structure of words. b. segmenting a word and blending the sounds together to form a word. c. the ability to manipulate sounds. d. active analysis and synthesis of information.

6. By about 10 years of age, awareness of and knowledge about which of the following is a better predictor of decoding ability? a. Morphological structure b. Ability to use context c. Phonological awareness d. Metacognition 16 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

7.

is knowing what to do and how to do it. a. Critical literacy b. Dynamic literacy c. Comprehension d. Metacognition

8. Dialogic reading is a. reading a child‟s book word-for-word. b. an interactive method of reading picture books. c. the most effective way to teach toddlers to read. d. not recommended until age 5.

9. Risk of reading problems is greatest for children with a history of problems in a. phonology and morphology. b. articulation and fluency. c. articulation and expressive/receptive language. d. hearing and receptive language.

10. Poor reading comprehenders have deficits in a. oral language comprehension. b. phonological abilities. c. metalinguistics. d. executive function.

11. Children with have poor comprehension but typical to aboveaverage word recognition ability; can occur in some children with A SD. a. alexia b. dysgraphia c. hyperlexia d. echolalia 12. When should phonological awareness intervention begin? a. During the babbling phase b. In preschool or kindergarten c. Whenever a child shows interest in reading d. Not until the child is two grade levels behind their peers 13. Postreading activities for text comprehension might include a. prediction activities.

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b. introduction of key vocabulary. c. decoding practice. d. story organizers.

14. Which of the following is used by more advanced readers? a. Whole-word recognition b. Distancing from the text c. Bridging inferences d. Looking up unknown vocabulary 15. Approximately, how many spelling words are explicitly taught in elementary school? a. 1,000 b. 4,000 c. 8,000 d. 10,000 16. Initial attempts at spelling are a. scribbling with occasional letters. b. correct pencil grasp and formation of at least five letters. c. correctly spelling one‟s name. d. not expected until kindergarten.

17. When do writers develop the cognitive abilities needed for mature writing? a. In early adolescence b. By junior year of high school c. By early adulthood d. By middle age 18. What is the best method for assessing developmental writing in young elementary school children? a. Expository writing b. Narrative samples c. Spelling analysis d. Writing to dictation 19. What is the best method for assessing developmental writing in adolescents? a. Expository writing b. Narrative samples c. Spelling analysis 18 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

d. Writing to dictation 20. Children with LD who receive training in along with word processing make greater gains in the quality of their writing. a. decoding b. phonological awareness c. executive functioning d. multisensory stimulation 21.

is the common event sequences and elements of a narrative. a. Story grammar b. Narration c. Brainstorming d. Exposition

22. What percentage of children with language disorders have difficulty in the area of literacy?

23. Describe the levels of text comprehension.

24. List skills involved in executive functioning.

25. Describe the process of print awareness.

26. What are the best predictors of kindergarten reading status?

27. What is mature literacy?

28. Describe the three types of specific learning disorder in literacy.

29. Why are many children with language impairments at risk for reading impairments?

30. As adolescents, poor readers exhibit deficits in what three areas?

31. Name three things that early literacy questionnaires ask about.

32. What are three things that comprehensive reading assessment should include?

33. Name some informal forms of assessment for phonological awareness.

34. Describe how deficits in executive function negatively affect writing.

35. Name three guidelines for assessment of word recognition that guide how evaluations should be conducted.

36. How can executive functioning be assessed in regard to developmental reading?

37. Describe the preliteracy skills of meaning foundation and form foundation.

38. What are three goals for word recognition intervention?

39. What are the four elements of the writing process?

40. How does mature literacy differ from emerging literacy in terms of writing?

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41. In what three ways do adults spell?

42. Name three ways spelling can be assessed.

43. Describe the assessment possibilities for text generation.

44. How should spelling words be chosen for intervention?

45. Explain the pros and cons of teaching children to use spell checkers to aid spelling.

46. Describe four ways that narrative text generation can be facilitated in writing intervention.

47. What are the six steps of Em-POWER, an intervention technique for writing?

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(d) Chapter 6 Test Answer Key 1. A (see page 174, Introduction) 2. B (see page 176, section titled “Reading”) 3. B (see page 181, section titled “Emerging Literacy”) 4. A (see page 178, section titled “Phonological Awareness”) 5. C (see page 178, section titled “Phonological Awareness”) 6. A (see page 178, section titled “Morphological Awareness”) 7. D (see page 179, section titled “Comprehension”) 8. B (see page 180, section titled “Emerging Literacy”) 9. C (see pages 182-183, section titled “Reading Disorders Through the Lifespan”) 10. A (see page 183, section titled “Reading Disorders Through the Lifespan”) 11. C (see page 184, section titled “Reading Disorders Through the Lifespan”) 12. B (see page 193, section titled “Phonological Awareness”) 13. D (see page 196, section titled “Text Comprehension”) 14. B (see page 198, section titled “Executive Function”) 15. B (see page 199, section titled “Spelling”) 16. A (see page 200, section titled “Spelling”) 17. C (see page 201, section titled “Executive Function”) 18. B (see page 204, section titled “Assessment of Developmental Writing”) 19. A (see page 204, section titled “Assessment of Developmental Writing”) 20. C (see page 209, section titled “Executive Function”) 21. A (see page 210, section titled “Narrative Text Generation”) 22. Answers should include the following points (see page 175, Introduction): As many as 60%.

23. Answers will vary, but should include some of the following points (see pages 178– 179, section titled “Comprehension”): At the basic level, the reader is primarily concerned with decoding. Meaning is actively constructed from words and sentences and from personal meaning and experiences. Critical literacy is active analysis and synthesis of information and an ability to explain content. Dynamic literacy is relating content to other knowledge through reasoning; comparing/contrasting, integrating, and using ideas for raising problems and solving them.

24. Answers will vary, but should include some of the following points (see page 179, section titled “Comprehension”): 21 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Self-regulation that includes the ability to attend; set reasonable goals; to plan and organize to achieve goals; to initiate, monitor, and evaluate performance in relation to goals; and to revise plans and strategies based on feedback.

25. Answers will vary, but should include some of the following points (see page 180, section titled “Emerging Literacy”): Early on, it consists of knowledge of the meaning and function of print, basic concepts concerning the direction print proceeds across a page and through a book, and recognition of some letters. Begins to develop around age 3. Later, it includes recognizing words as discrete units, being able to identify letters, and using terminology such as letter, word, and sentence.

26. Answers will vary, but should include some of the following points (see page 180, section titled “Emerging Literacy”): Oral language, alphabet knowledge, and print concept knowledge 27. Answers will vary, but should include some of the following points (see pages 181– 182, section titled “Mature Literacy”): Mature readers use very little cognitive energy determining word pronunciation.

Language and experience are used to understand the text, which is monitored to ensure the information makes sense. Prediction of the next word or phrase aids quick processing. Reading is an active process and one of the primary ways adults increase vocabulary and knowledge.

28. Answers will vary, but should include some of the following points (see page 183, section titled “Reading Disorders Through the Lifespan”): A language-based disorder that may affect comprehension and/or speech sound discrimination. A speech/motor disorder that may affect speech sound blending and motor coordination. Visuospatial disorder that may affect letter form discrimination.

The language-based disorder is the most common.

29. Answers will vary, but should include some of the following points (see page 186, section titled “Reading Disorders Through the Lifespan”): In general, they begin with less language and have difficulty catching up. Have poor comprehension skills because they lack language knowledge that would enable them to integrate what they read. Have poor metalinguistic skills. Possess linguistic processing difficulties.

30. Answers will vary, but should include some of the following points (see page 186, section titled Reading Disorders Through the Lifespan”): Vocabulary, grammar, and verbal memory 31. Answers will vary, but should include some of the following points (see page 188, section titled “Assessment of Developmental Reading”): Frequency of book reading, responses to print, language awareness, interest in letters, early writing.

32. Answers will vary, but should include some of the following points (see page 188, 22 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

section titled “Assessment of Developmental Reading”): Standardized measures, oral language samples, and written story retelling 33. Answers will vary, but should include some of the following points (see page 188, section titled “Phonological Awareness”): Address rhyming, syllabication, segmentation, phoneme isolation, deletion, substitution, and blending 34. Answers will vary, but should include some of the following points (see page 203, section titled “Deficits in Executive Function”): Some children with LD write whatever comes to mind, with little planning. They produce and elaborate little, revise ineffectively and with seeming indifference to the audience, detect errors poorly, and experience difficulty executing intended changes. Planning is difficult because of language formulation difficulties.

35. Answers will vary, but should include some of the following points (see pages 188 and 190, section titled “Word Recognition”): Three of the following: Materials should be age and developmentally appropriate; tasks should be of various types to assess different levels of processing; several measures should be used; cultural and linguistic background must be considered; unfamiliar tasks need to be demonstrated and trained; reading deficits are not limited to children with emergent literacy skills; observation and interpretation of test behaviors is important.

36. Answers will vary, but should include some of the following points (see page 191, section titled “Executive Function”): Self-regulation in reading can be assessed by: Interview questions about different strategies used for different reading tasks; Think-alouds or verbalizing thoughts accompanying reading; Error or inconsistency detection while reading.

37. Answers will vary, but should include some of the following points (see page 192, section titled “Intervention for Developmental Reading Disorder”): Meaning foundation refers to vocabulary and sentence-level semantic-syntactic skills, whereas form foundation refers to learning about the alphabet and becoming aware of phonological units within spoken words.

38. Answers will vary, but should include some of the following points (see page 195, section titled “Word Recognition”): Teach decoding skills, develop a vocabulary of written words, and improve reading comprehension.

39. Answers will vary, but should include some of the following points (see page 199, section titled “Writing”): Spelling, executive function, text construction (going from ideas to writing), memory 40. Answers will vary, but should include some of the following points (see page 200, sections titled “Emerging Literacy” and “Mature Literacy”): 23 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

For some mature writers, speaking and writing become consciously separate. The writing of adults contains longer, more complex sentences and uses more abstract nouns and more metalinguistic words.

41. Answers will vary, but should include some of the following points (see page 201, section titled “Spelling”): Letter-by-letter, by syllable, and by sub-syllable unit 42. Answers will vary, but should include some of the following points (see page 205, section titled “Assessment of Spelling”): Through dictation, connected writing, and standardized assessment 43. Answers will vary, but should include some of the following points (see page 205, section titled “Assessment of Text Generation”): Writing analysis can include total number of words and number of different words used. Other measures include word choice, clause and sentence length, and coherence.

44. Answers will vary, but should include some of the following points (see page 208, section titled “Spelling”): Words selected for intervention should be individualized and reflect the curriculum, the child‟s desires, words attempted but in error, and error patterns.

45. Answers will vary, but should include some of the following points (see page 209, section titled “Spelling”): Spell checkers help less for children with LD than for children developing typically. If children with literacy impairments are taught to spell phonetically when unsure of the correct spelling, spell checkers generate more correct suggestions.

46. Answers will vary, but should include some of the following points (see page 210, section titled “Narrative Text Generation”): Four of the following: Writing can be guided through brainstorming, story guides, prompts, acronyms, and story maps, as well as explicit instruction in story grammar or structure.

47. Answers will vary, but should include some of the following points (see page 210, section titled “Expository Text Generation”): Treats writing as a problem-solving task involving six steps: Evaluate, Make a Plan, Organize, Work, Evaluate, and Rework.

Article VII. Chapter 7 Test Item File 24 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Introduction to Communication Disorders A Lifespan Evidence-Based Perspective

Seventh Edition

Dr. Robert E. Owens, College of St. Rose Dr. Kimberly A. Farinella, Northern Arizona University

Prepared by

Dr. Sarah A. Dachtyl

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Section 7.01

Table of Contents

Chapter 7: Acquired Adult Language Disorders

1

Learning Objective Quizzes

1

Application Exercises

16

Test Items

19

Test Answer Key

28

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Section 7.02 Chapter 7: Acquired Adult Language Disorders (a) Chapter 7 Learning Objective Quizzes Learning Objective 7.1: Outline language development beyond childhood.

[Q1] Which of the following individuals is most likely to make more language form errors?

1. Helen is 80 years old. [correct] 2. Orville is 70 years old.

3. Jeanette is 60 years old.

4. Thomas is 50 years old.

[Feedback for Correct Answer 1] Those over age 75 have less flexibility and ease with word retrieval and make more language form errors.

[Feedback for Answer Choice 2] Those over age 75 have less flexibility and ease with word retrieval and make more language form errors. Orville is not yet 75 years old and is less likely to make more language form errors.

[Feedback for Answer Choice 3] Those over age 75 have less flexibility and ease with word retrieval and make more language form errors. Jeanette is not yet 75 years old and is less likely to make more language form errors.

[Feedback for Answer Choice 4] Those over age 75 have less flexibility and ease with word retrieval and make more language form errors. Thomas is not yet 75 years old and is less likely to make more language form errors.

[Q2] In advanced age, there is a decline in oral/written language comprehension, understanding complex syntax, and .

1. use of prefixes.

2. morphophonemic contrasts.

3. inferencing. [correct] 4. irregular verbs.

[Feedback for Answer Choice 1]

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In advanced age, there is a decline in oral/written language comprehension, understanding complex syntax, and inferencing. There is not likely a decline in use of prefixes.

[Feedback for Answer Choice 2] In advanced age, there is a decline in oral/written language comprehension, understanding complex syntax, and inferencing. There is not likely a decline in use of morphophonemic contrasts.

[Feedback for Correct Answer 3] In advanced age, there is a decline in oral/written language comprehension, understanding complex syntax, and inferencing.

[Feedback for Answer Choice 4] In advanced age, there is a decline in oral/written language comprehension, understanding complex syntax, and inferencing. There is not likely a decline in use of irregular verbs.

[Q3] Throughout adulthood, conversations become more cohesive through effective use of .

1. conjunctions.

2. linguistic devices. [correct] 3. prosody.

4. indefinite words.

[Feedback for Answer Choice 1] Throughout adulthood, conversations become more cohesive through more effective use of linguistic devices, rather than conjunctions alone.

[Feedback for Correct Answer 2] Throughout adulthood, conversations become more cohesive through more effective use of linguistic devices.

[Feedback for Answer Choice 3] Throughout adulthood, conversations become more cohesive through more effective use of linguistic devices, rather than prosody.

[Feedback for Answer Choice 4] Throughout adulthood, conversations become more cohesive through more effective use of linguistic devices, rather than indefinite words.

Learning Objective 7.2: Describe the main parts of the nervous system that are related to speech and language.

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[Q1] In of individuals, the left hemisphere is dominant for most aspects of receptive and expressive language processing.

1. 58% 2. 66% 3. 87% 4. 98% [correct] [Feedback for Answer Choice 1] In 98% of individuals, the left hemisphere is dominant for most aspects of receptive and expressive language processing. Fifty-eight percent is too low.

[Feedback for Answer Choice 2] In 98% of individuals, the left hemisphere is dominant for most aspects of receptive and expressive language processing. Sixty-six percent is too low.

[Feedback for Answer Choice 3] In 98% of individuals, the left hemisphere is dominant for most aspects of receptive and expressive language processing. Eighty-seven percent is too low.

[Feedback for Correct Answer 4] In 98% of individuals, the left hemisphere is dominant for most aspects of receptive and expressive language processing.

[Q2] The language.

regions of the left hemisphere appear to be important for

1. frontal and parietal 2. parietal and temporal 3. parietal and occipital 4. frontal and temporal [correct] [Feedback for Answer Choice 1] The frontal and temporal regions of the left hemisphere appear to be important for language. The parietal lobe is not one of the two main contributors to language.

[Feedback for Answer Choice 2] The frontal and temporal regions of the left hemisphere appear to be important for language. The parietal lobe is not one of the two main contributors to language.

[Feedback for Answer Choice 3]

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The frontal and temporal regions of the left hemisphere appear to be important for language. The parietal and occipital lobes are not the two main contributors to language.

[Feedback for Correct Answer 4] The frontal and temporal regions of the left hemisphere appear to be important for language.

[Q3] For outgoing information, the message is held in working memory in .

1. Wernicke‟s area.

2. Broca‟s area. [correct] 3. the supramarginal gyrus.

4. the angular gyrus.

[Feedback for Answer Choice 1] For outgoing information, concepts are formed, and the angular gyrus and supramarginal gyrus contribute to the overall message formation that occurs in Wernicke‟s area while held in working memory in Broca‟s area.

[Feedback for Correct Answer 2] For outgoing information, concepts are formed, and the angular gyrus and supramarginal gyrus contribute to the overall message formation that occurs in Wernicke‟s area while held in working memory in Broca‟s area.

[Feedback for Answer Choice 3] For outgoing information, concepts are formed, and the angular gyrus and supramarginal gyrus contribute to the overall message formation that occurs in Wernicke‟s area while held in working memory in Broca‟s area.

[Feedback for Answer Choice 4] For outgoing information, concepts are formed, and the angular gyrus and supramarginal gyrus contribute to the overall message formation that occurs in Wernicke‟s area while held in working memory in Broca‟s area.

Learning Objective 7.3: Discuss the different types of aphasia, concomitant or accompanying deficits, and assessment and intervention considerations.

[Q1] Aphasia is not a result of a motor speech impairment, cognitive impairment, or .

1. impaired language.

2. impaired word retrieval.

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3. deterioration intelligence. [correct] 4. impaired comprehension.

[Feedback for Answer Choice 1] Aphasia is not a result of a motor speech impairment, cognitive impairment or dementia, or deterioration of intelligence. Language is impaired in those with aphasia.

[Feedback for Answer Choice 2] Aphasia is not a result of a motor speech impairment, cognitive impairment or dementia, or deterioration of intelligence. Those with aphasia do experience impaired word retrieval.

[Feedback for Correct Answer 3] Aphasia is not a result of a motor speech impairment, cognitive impairment or dementia, or deterioration of intelligence.

[Feedback for Answer Choice 4] Aphasia is not a result of a motor speech impairment, cognitive impairment or dementia, or deterioration of intelligence. Those with aphasia do experience some degree of impaired comprehension.

[Q2] In non-fluent aphasias, the lesion is in or near the 1. frontal lobe. [correct] 2. parietal lobe.

3. temporal lobe.

4. occipital lobe.

[Feedback for Correct Answer 1] In general, the site of lesion for non-fluent aphasia is in or near the frontal lobe.

[Feedback for Answer Choice 2] In general, the site of lesion for non-fluent aphasia is in or near the frontal lobe, rather than the parietal lobe.

[Feedback for Answer Choice 3] In general, the site of lesion for non-fluent aphasia is in or near the frontal lobe, rather than the temporal lobe.

[Feedback for Answer Choice 4] In general, the site of lesion for non-fluent aphasia is in or near the frontal lobe, rather than the occipital lobe.

[Q3] 5 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Which of the following individuals is exhibiting signs of fluent aphasia?

1. Mrs. Hansen exhibits slow, labored speech.

2. Mr. Blake exhibits verbosity. [correct] 3. Mr. Wynn uses short sentences.

4. Mrs. Hardy exhibits agrammatism.

[Feedback for Answer Choice 1] Fluent aphasia is characterized by word substitutions, neologisms, and often verbose verbal output. Slow, labored speech is a characteristic of non-fluent aphasia.

[Feedback for Correct Answer 2] Fluent aphasia is characterized by word substitutions, neologisms, and often verbose verbal output.

[Feedback for Answer Choice 3] Fluent aphasia is characterized by word substitutions, neologisms, and often verbose verbal output. Use of short sentences is a characteristic of non-fluent aphasia.

[Feedback for Answer Choice 4] Fluent aphasia is characterized by word substitutions, neologisms, and often verbose verbal output. Agrammatism is a characteristic of non-fluent aphasia.

[Q4] is a natural, immediate physiological restorative process.

1. Extent of recovery 2. Course of recovery 3. Speed of recovery 4. Spontaneous recovery [correct] [Feedback for Answer Choice 1] Spontaneous recovery is a natural, immediate physiological restorative process. The extent of recovery is the degree to which an individual returns to their pre-injury status.

[Feedback for Answer Choice 2] Spontaneous recovery is a natural, immediate physiological restorative process. The course of recovery is the path the individual‟s recovery takes.

[Feedback for Answer Choice 3] Spontaneous recovery is a natural, immediate physiological restorative process. The speed of recovery refers to how quickly the individual recovers.

[Feedback for Correct Answer 4] Spontaneous recovery is a natural, immediate physiological restorative process.

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[Q5] Because Mrs. Zella is a high functioning individual with aphasia, which of the following will her speech-language pathologist (SLP) include in the assessment process that is not included in all aphasia evaluations?

1. Auditory comprehension 2. Verbal reasoning [correct] 3. Naming 4. Syntax [Feedback for Answer Choice 1] With higher-functioning clients, an SLP will assess verbal reasoning and analogies, figurative language, categorization, and explanations of complex tasks. Auditory comprehension is part of every assessment for aphasia and is not specific to those who are higher functioning.

[Feedback for Correct Answer 2] With higher-functioning clients, an SLP will assess verbal reasoning and analogies, figurative language, categorization, and explanations of complex tasks.

[Feedback for Answer Choice 3] With higher-functioning clients, an SLP will assess verbal reasoning and analogies, figurative language, categorization, and explanations of complex tasks. Naming is part of every assessment for aphasia and is not specific to those who are higher functioning.

[Feedback for Answer Choice 4] With higher-functioning clients, an SLP will assess verbal reasoning and analogies, figurative language, categorization, and explanations of complex tasks. Syntax is part of every assessment for aphasia and is not specific to those who are higher functioning.

[Q6] After Mr. Chadwick participated in a conversation-based intervention for aphasia, which of the following outcomes did he likely experience?

1. Improved syntax 2. Shorter repair times [correct] 3. Improved semantics 4. Improved noun naming [Feedback for Answer Choice 1] Following conversation-based intervention, conversational skills can become more efficient with fewer difficulties and shorter repair times. Improved syntax is not noted in this chapter as a typical outcome.

[Feedback for Correct Answer 2] 7 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Following conversation-based intervention, conversational skills can become more efficient with fewer difficulties and shorter repair times.

[Feedback for Answer Choice 3] Following conversation-based intervention, conversational skills can become more efficient with fewer difficulties and shorter repair times. Improved semantics is not noted in this chapter as a typical outcome.

[Feedback for Answer Choice 4] Following conversation-based intervention, conversational skills can become more efficient with fewer difficulties and shorter repair times. Improved noun naming is not noted in this chapter as a typical outcome.

[Q7] Primary progressive aphasia takes at least

to develop.

1. 6 months 2. 2 years [correct] 3. 4 years 4. 5 years [Feedback for Answer Choice 1] Primary progressive aphasia takes at least 2 years to develop and over its course progresses from primarily a motor speech disorder to a near-total inability to speak.

[Feedback for Correct Answer 2] Primary progressive aphasia takes at least 2 years to develop and over its course progresses from primarily a motor speech disorder to a near-total inability to speak.

[Feedback for Answer Choice 3] Primary progressive aphasia takes at least 2 years to develop and over its course progresses from primarily a motor speech disorder to a near-total inability to speak.

[Feedback for Answer Choice 4] Primary progressive aphasia takes at least 2 years to develop and over its course progresses from primarily a motor speech disorder to a near-total inability to speak.

Learning Objective 7.4: Describe right hemisphere damage and assessment and intervention considerations.

[Q1] The right hemisphere plays a significant role in which of the following?

1. Understanding of figurative language [correct] 2. Mathematical ability

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3. Understanding of complex syntax 4. Naming [Feedback for Correct Answer 1] Nonlinguistic and paralinguistic information are processed in the right hemisphere; the right hemisphere plays a role in some aspects of pragmatics, including the perception and expression of emotion; understanding of jokes, irony, and figurative language, and production and comprehension of coherent discourse, as well as processing emotion.

[Feedback for Answer Choice 2] Nonlinguistic and paralinguistic information are processed in the right hemisphere; the right hemisphere plays a role in some aspects of pragmatics, including the perception and expression of emotion; understanding of jokes, irony, and figurative language, and production and comprehension of coherent discourse, as well as processing emotion.

Mathematical ability is not included.

[Feedback for Answer Choice 3] Nonlinguistic and paralinguistic information are processed in the right hemisphere; the right hemisphere plays a role in some aspects of pragmatics, including the perception and expression of emotion; understanding of jokes, irony, and figurative language, and production and comprehension of coherent discourse, as well as processing emotion.

Understanding of complex syntax is not included.

[Feedback for Answer Choice 4] Nonlinguistic and paralinguistic information are processed in the right hemisphere; the right hemisphere plays a role in some aspects of pragmatics, including the perception and expression of emotion; understanding of jokes, irony, and figurative language, and production and comprehension of coherent discourse, as well as processing emotion.

Naming is not included.

[Q2] Clients with right hemisphere damage exhibit poor judgment in determining 1. the meanings of words.

2. how to count money and perform mathematical operations.

3. which incoming information is important and which is not. [correct] 4. how quickly to speak.

[Feedback for Answer Choice 1] Clients with right hemisphere damage exhibit poor judgment in determining which incoming information is important and which is not. Determining the meanings of words is not related to impaired judgment after R HD. [Feedback for Answer Choice 2] 9 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Clients with right hemisphere damage exhibit poor judgment in determining which incoming information is important and which is not. Counting money and performing mathematical operations is not related to impaired judgment after RHD. [Feedback for Correct Answer 3] Clients with right hemisphere damage exhibit poor judgment in determining which incoming information is important and which is not.

[Feedback for Answer Choice 4] Clients with right hemisphere damage exhibit poor judgment in determining which incoming information is important and which is not. Determining speaking rate is not related to impaired judgment after RHD. [Q3] After Mr. McCowin‟s right hemisphere stroke, his SLP included sampling and observation to thoroughly examine , specifically.

1. phonology 2. syntax 3. semantics 4. pragmatics [correct] [Feedback for Answer Choice 1] Sampling and observations are essential in assessing the client‟s pragmatic abilities.

Sampling and observations are not as vital for phonology.

[Feedback for Answer Choice 2] Sampling and observations are essential in assessing the client‟s pragmatic abilities.

Sampling and observations are not as vital for syntax.

[Feedback for Answer Choice 3] Sampling and observations are essential in assessing the client‟s pragmatic abilities.

Sampling and observations are not as vital for semantics.

[Feedback for Correct Answer 4] Sampling and observations are essential in assessing the client‟s pragmatic abilities.

[Q4] After right hemisphere damage, organize linguistic content and improve relevance.

and explaining actions help

1. contextual prestimulation 2. sequencing [correct] 3. describing 4. imitation 10 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

[Feedback for Answer Choice 1] Sequencing and explaining actions help organize linguistic content and improve relevance. Intervention for activating meanings and for suppression of noncontextual ones can be accomplished through contextual stimulation, where a client is given sentences to activate different meanings prior to being given a word.

[Feedback for Correct Answer 2] Sequencing and explaining actions help organize linguistic content and improve relevance.

[Feedback for Answer Choice 3] Sequencing and explaining actions help organize linguistic content and improve relevance, rather than describing.

[Feedback for Answer Choice 4] Sequencing and explaining actions help organize linguistic content and improve relevance, rather than imitation.

Learning Objective 7.5: Describe traumatic brain injury and assessment and intervention considerations.

[Q1] Severity of traumatic brain injury symptoms are related to initial levels of consciousness and 1. vision problems 2. post-traumatic amnesia [correct] 3. disinhibition 4. aggressiveness [Feedback for Answer Choice 1] Severity seems to be related to initial levels of consciousness and post-traumatic amnesia, rather than vision problems.

[Feedback for Correct Answer 2] Severity seems to be related to initial levels of consciousness and post-traumatic amnesia.

[Feedback for Answer Choice 3] Severity seems to be related to initial levels of consciousness and post-traumatic amnesia, rather than disinhibition.

[Feedback for Answer Choice 4] Severity seems to be related to initial levels of consciousness and post-traumatic amnesia, rather than aggressiveness.

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[Q2] Most individuals who sustain a traumatic brain injury have lingering deficits, particularly in 1. syntax.

2. semantics.

3. morphology.

4. pragmatics. [correct] [Feedback for Answer Choice 1] Most individuals who sustain a traumatic brain injury will have lingering deficits, especially in pragmatics. Syntax is less likely to be impaired long term.

[Feedback for Answer Choice 2] Most individuals who sustain a traumatic brain injury will have lingering deficits, especially in pragmatics. Semantics is less likely to be impaired long term.

[Feedback for Answer Choice 3] Most individuals who sustain a traumatic brain injury will have lingering deficits, especially in pragmatics. Morphology is less likely to be impaired long term.

[Feedback for Correct Answer 4] Most individuals who sustain a traumatic brain injury will have lingering deficits, especially in pragmatics.

[Q3] can increase client motivation and functional outcomes for those with traumatic brain injury and high self-awareness.

1. Collaborative goal setting [correct] 2. Video modeling 3. Sensorimotor stimulation 4. Memory therapy [Feedback for Correct Answer 1] Collaborative client-clinician models of goal setting can increase client motivation and functional outcomes for those with mild T BI and high self-awareness.

[Feedback for Answer Choice 2] Collaborative client-clinician models of goal setting can increase client motivation and functional outcomes for those with mild TBI and high self-awareness. Video modeling can be important but not in relation to motivation.

[Feedback for Answer Choice 3]

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Collaborative client-clinician models of goal setting can increase client motivation and functional outcomes for those with mild TBI and high self-awareness. Sensorimotor stimulation can be important but not in relation to motivation.

[Feedback for Answer Choice 4] Collaborative client-clinician models of goal setting can increase client motivation and functional outcomes for those with mild TBI and high self-awareness. Memory therapy is not directly related to motivation.

Learning Objective 7.6: Describe cognitive impairment and assessment and intervention considerations.

[Q1] In regard to cognitive impairment in older adults, obvious function affected.

is the most

1. orientation 2. memory [correct] 3. visuospatial skills 4. auditory comprehension [Feedback for Answer Choice 1] In older adults with cognitive impairment, memory is the most obvious function affected.

Orientation, visuospatial skills, and auditory comprehension may also be impacted but are not primary.

[Feedback for Correct Answer 2] In older adults with cognitive impairment, memory is the most obvious function affected.

[Feedback for Answer Choice 3] In older adults with cognitive impairment, memory is the most obvious function affected.

Orientation, visuospatial skills, and auditory comprehension may also be impacted but are not primary.

[Feedback for Answer Choice 4] In older adults with cognitive impairment, memory is the most obvious function affected.

Orientation, visuospatial skills, and auditory comprehension may also be impacted but are not primary.

[Q2] The neuropathology related to Alzheimer‟s disease includes the presence of twisted neurofilaments that deteriorate cell function. This is most pronounced in which lobe of the brain?

1. Frontal lobe 2. Parietal lobe 13 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

3. Occipital lobe 4. Temporal lobe [correct] [Feedback for Answer Choice 1] The neuropathology in Alzheimer's disease is characterized by the presence of twisted neurofilaments that deteriorate cell functioning; most pronounced in the temporal lobe and associational parts of the brain.

[Feedback for Answer Choice 2] The neuropathology in Alzheimer's disease is characterized by the presence of twisted neurofilaments that deteriorate cell functioning; most pronounced in the temporal lobe and associational parts of the brain.

[Feedback for Answer Choice 3] The neuropathology in Alzheimer's disease is characterized by the presence of twisted neurofilaments that deteriorate cell functioning; most pronounced in the temporal lobe and associational parts of the brain.

[Feedback for Correct Answer 4] The neuropathology in Alzheimer's disease is characterized by the presence of twisted neurofilaments that deteriorate cell functioning; most pronounced in the temporal lobe and associational parts of the brain.

[Q3] Assessment of in dementia is important because it may precede other cognitive and language deficits.

1. written language [correct] 2. attention 3. working memory 4. motor control [Feedback for Correct Answer 1] Writing assessment is important because written language may precede other cognitive and spoken language deficits.

[Feedback for Answer Choice 2] Writing assessment is important because written language may precede other cognitive and spoken language deficits. Attention deficits are not often a first symptom.

[Feedback for Answer Choice 3] Writing assessment is important because written language may precede other cognitive and spoken language deficits. Working memory deficits are not often a first symptom.

[Feedback for Answer Choice 4]

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Writing assessment is important because written language may precede other cognitive and spoken language deficits. Motor control deficits are not often a first symptom.

[Q4] Mindy, an SLP in a skilled nursing facility, is using an evidence-based treatment for Mrs. Walker, a patient who has dementia. Which of the following does she use?

1. Semantic feature analysis 2. Cross-modality intervention 3. Cognitive-linguistic treatment 4. Spaced retrieval training [correct] [Feedback for Answer Choice 1] Interventions for dementia include computer-assisted cognitive interventions, reminiscence therapy, errorless learning, simulated presence therapy, spaced retrieval, and vanishing cues, as well as indirect interventions. Semantic feature analysis is an aphasia treatment.

[Feedback for Answer Choice 2] Interventions for dementia include computer-assisted cognitive interventions, reminiscence therapy, errorless learning, simulated presence therapy, spaced retrieval, and vanishing cues, as well as indirect interventions. Cross-modality intervention is used in aphasia.

[Feedback for Answer Choice 3] Interventions for dementia include computer-assisted cognitive interventions, reminiscence therapy, errorless learning, simulated presence therapy, spaced retrieval, and vanishing cues, as well as indirect interventions. Cognitive-linguistic treatment is used for expressive aprosodia, most frequently after right-hemisphere damage.

[Feedback for Correct Answer 4] Interventions for dementia include computer-assisted cognitive interventions, reminiscence therapy, errorless learning, simulated presence therapy, spaced retrieval, and vanishing cues, as well as indirect interventions.

15 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

(b) Chapter 7 Application Exercises Application Exercise 7.1: Describe a patient‟s experience with aphasia.

Learning Objective 7.3: Discuss the different types of aphasia, concomitant or accompanying deficits, and assessment and intervention considerations.

Reference: Case Study: Marsha (see page 233) [Q1] Use Case Study: Marsha (see page 233) to answer the following question: In this case study, when did speech-language intervention begin for Marsha after she experienced a stroke?

[Q1 Model Response] As soon as her condition had stabilized.

[Q2] Use Case Study: Marsha (see page 233) to answer the following question: What symptoms did Marsha experience related to communication?

[Q2 Model Response] Marsha experienced comprehension deficits, which improved quickly. Her speech was rapid with frequent word substitutions and misarticulation of words.

[Q3] Use Case Study: Marsha (see page 233) to answer the following question: How were Marsha‟s intervention sessions structured?

[Q3 Model Response] Intervention sessions were lively and contained give-and-take between her and her SL P. The SLP used Marsha‟s improved comprehension to improve language production.

Application Exercise 7.2: Describe intervention for right-hemisphere disorders.

Learning Objective 7.4: Describe right-hemisphere damage and assessment and intervention considerations.

Reference: Box 7.2 (page 248) [Q1] Use Box 7.2 (page 248) to answer the following question: Based on the information related to evidence-based practice for right hemisphere disorders in Box 7.2, what are the effects of cognitive rehabilitation intervention?

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[Q1 Model Response] Cognitive rehabilitation intervention has positive effects on attention, functional communication, memory, and problem solving. Approximately 70–80% of clients who receive SLP intervention services make significant measurable improvements in communication.

[Q2] Use Box 7.2 (page 248) to answer the following question: What types of intervention result in greater independence in daily living and return to modified word programs for this population?

[Q2 Model Response] Communication services as part of a broader interdisciplinary approach including physical, emotional, vocational, and communication, plus family education and support, resulted in greater independence in daily living and return to modified work programs.

[Q3] Use Box 7.2 (page 248) to answer the following question: Based on the information in Box 7.2, what types of pragmatic interventions have been examined and what are the results?

[Q3 Model Response] Pragmatic intervention, whether a social skills-based treatment using a combination of video-recorded feedback, modeling, coaching, and rehearsal strategies or an auditory stimulation approach to enhance attending and attentional control, has mixed results.

Application Exercise 7.3: Describe treatment for traumatic brain injury.

Learning Objective 7.5: Describe traumatic brain injury and assessment and intervention considerations.

Reference: Pearson eText Video Example 7.8 [Q1] Use Pearson eText Video Example 7.8 to answer the following question: According to Barbara Brinkman, C CC/SLP, when does an SLP become involved when working with a patient post-TBI? [Q1 Model Response] Ms. Brinkman states that SLPs usually get involved very early on after an individual sustains a TBI. If a patient is in a deep coma, an SLP can be involved in providing stimulation to try to help get them out of that stage of coma.

[Q2] 17 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Use Pearson eText Video Example 7.8 to answer the following question: After an individual emerges from a coma, what might an SLP target in intervention?

[Q2 Model Response] Depending on the patient‟s deficits, an SLP might target reading, writing, listening, speaking, and/or swallowing.

[Q3] Use Pearson eText Video Example 7.8 to answer the following question: What are the goals of speech/language treatment for traumatic brain injury?

[Q3 Model Response] The goal is to integrate the person back into their former life as much as possible, so it depends on the patient. For example, if the patient is a school-aged child, the goal would be to integrate them back into the school system.

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(c) Chapter 7 Test Items 1. The

is the basic unit of the nervous system.

a. dendrite b. cell c. glioma d. neuron 2. A nerve is a. a collection of neurons. b. another name for a neuron. c. only found in the brain. d. composed of dendrites.

3. The space across which electrochemical impulses pass between neurons is the a. dendrite. b. axon. c. synapse. d. cleft.

4. The brain consists of the a. cerebrum, nerves, cerebellum. b. cerebellum, brainstem, spinal cord. c. brainsteam, cerebrum, sensory organs. d. cerebrum, cerebellum, brainstem.

5. The

is important in decision making and motor control.

a. frontal lobe b. parietal lobe c. temporal lobe d. occipital lobe 6. The adaptive capacity of the central nervous system is referred to as a. compensation. b. stimulability. c. generalization. d. plasticity.

7. In most individuals, linguistic information is processed 19 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

a. in the right hemisphere. b. in the left hemisphere. c. bilaterally. d. in the frontal lobes.

8. Nonlinguistic and paralinguistic information are processed primarily a. in the right hemisphere. b. in the left hemisphere. c. bilaterally. d. in the frontal lobes.

9. Incoming auditory information is held in working memory in frontal lobe while it is processed.

in the

a. Wernicke‟s area b. Broca‟s area c. the hippocampus d. the supplementary motor area 10. Most incoming linguistic processing occurs in in the left temporal lobe, assisted by the angular gyrus for words and the supramarginal gyrus for grammar. a. Wernicke‟s area b. Broca‟s area c. the hippocampus d. the central sulcus 11. Broca‟s area sends programming information to the sends signals to the motor neurons for speech.

, which

a. pontine angle b. thalamus c. motor cortex d. basal ganglia 12. The aphasic population is extremely diverse, but which characteristics are common to all aphasias? a. Deficits in naming and fluency b. Difficulty in auditory comprehension and word retrieval c. Difficulty with reading and writing d. Difficulty with facial recognition 20 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

13. Individuals who have fluent, sometimes incoherent speech and speak in a rapid-fire manner with few pauses and opportunity for turn taking most likely have which type of aphasia? a. Wernicke‟s b. Anomic c. Conduction d. Transcortical sensory 14. Individuals who have fluent, relatively preserved language abilities aside from naming difficulty most likely have which type of aphasia? a. Wernicke‟s b. Anomic c. Transcortical sensory d. Subcortical 15. Individuals who have fluent, abundant, and quick conversations filled with paraphasia most likely have which type of aphasia? a. Wernicke‟s b. Conduction c. Transcortical sensory d. Subcortical 16. Individuals who have fluent conversation filled with word errors most likely have which type of aphasia? a. Conduction b. Anomic c. Transcortical sensory d. Subcortical 17. Individuals who speak in short sentences with agrammatism, have labored speech and writing, and demonstrate articulation and phonological errors most likely have which type of aphasia? a. Broca‟s b. Transcortical motor c. Global/mixed d. Crossed aphasia 18. Individuals who demonstrate difficulty initiating speech or writing and severely impaired speech most likely have which type of aphasia? a. Broca‟s 21 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

b. Transcortical motor c. Global/mixed d. Crossed aphasia 19. Individuals who have profound language impairments in all modalities most likely have which type of aphasia? a. Broca‟s b. Transcortical motor c. Global/mixed d. Crossed aphasia 20. The most common cause of aphasia is a. stroke. b. heart attack. c. traumatic brain injury. d. anoxia.

21. As a result of stroke

people become aphasic each year.

a. 10,000 b. 58,000 c. 180,000 d. 500,000 22.

is a neurodegenerative disorder of language with initial preservation of other mental functions and of activities of daily living. a. Neural infection b. Primary progressive aphasia c. Mild cognitive impairment d. Amyotrophic lateral sclerosis

23. The most frequent linguistic gains after stroke are in a. syntax. b. auditory comprehension. c. lexical retrieval. d. repetition.

24. Maximum spontaneous recovery after stroke occurs a. in the first 3 months. b. in the first 6 months.

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c. in the first 3 weeks. d. in the first month.

25. When do assessment and intervention begin after stroke? a. As soon as the individual enters the rehabilitation hospital b. Not until neuroimaging is complete c. As soon as the client‟s condition permits d. When the client can verbalize that he/she wants therapy and can state their needs 26. Formal testing for aphasia is usually a. postponed until the client is stable. b. conducted weekly to determine change. c. is not necessary. d. conducted as soon as the client is alert.

27. Using gestures and pantomime might have a positive effect on a. syntactical structure. b. noun retrieval. c. social interaction. d. auditory comprehension.

28. Evidence-based practice in aphasia shows that a. cross-modality generalization is most effective. b. “bridging” is most effective. c. conversational techniques are most effective. d. we cannot definitively say which interventions methods are best.

29.

of individuals with right hemisphere damage exhibit one or more communication impairments, but many do not receive treatment. a. 10–15% b. 25–47% c. 50–78% d. 80–90%

30. The right hemisphere is important for activation of a. distant word and sentence meanings b. visual comprehension c. phonological information 23 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

.

d. mathematical computations 31. Paralinguistic deficits include difficulty comprehending and producing a. narratives. b. emotional language. c. topics of conversation. d. expository discourse.

32.

is the reduced ability or inability to produce or comprehend affective aspects of language. a. Prosopagnosia b. Anosognosia c. Aprosodia d. Voice immodulation disorder

33. For , clients may imitate a sentence in unison with the SLP, or use cognitive-linguistic treatment in which cues are used to modify this domain. a. expressive aprosodia b. receptive aprosodia c. lexical stress impairment d. emotional stress impairment 34. For interpretation of , a semantic intervention approach may be used where word meaning and connotations are mapped and diagrammed. a. receptive aprosodia b. figurative language c. tangentiality d. complex syntax 35. Intervention for activating meanings and for suppression of noncontextual ones can be accomplished through , where a client is given sentences to activate different meanings prior to being given a word. a. time constraints b. sequencing c. contextual prestimulation d. multiple meaning words 36.

is a disruption in normal functioning caused by a blow or jolt to the head or a penetrating injury. a. Traumatic brain injury

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b. Stroke c. Edema d. Meningitis 37. Annually,

people sustain T BI in the United States.

a. 500,000 b. 750,000 c. 1 million d. 1.7 million 38. Language may be affected in

of individuals with TBI.

a. 25% b. 50% c. 75% d. 100% 39. Approximately, one-third of individuals with T BI demonstrate a. dysthymia. b. dyslexia. c. dysgraphia. d. dysarthria.

40. The late stages of recovery from TBI include which intervention? a. Sensorimotor stimulation b. A focus on orientation c. Reducing confusion d. Comprehension of complex information and directions, conversation, and social skills 41. Fewer than

of the elderly experience cognitive impairment.

a. 1% b. 3% c. 10% d. 15% 42.

is an umbrella term for a group of both pathological conditions and syndromes that result in declining of memory and at least one other cognitive ability that is significant enough to interfere with daily life activities. a. Aphasia

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b. TBI c. Cognitive impairment d. Dysarthria 43.

include Alzeheimer‟s and Pick‟s diseases and resemble those of focal impairments such as aphasia and RHD, including visuospatial deficits, memory problems, judgment and abstract thinking disturbances, and language deficits in naming, reading and writing, and auditory comprehension. a. Cortical cognitive impairments b. Subcortical cognitive impairments c. Focal cognitive impairments d. Diffuse cognitive impairments

44. Describe how language use changes through adulthood.

45. Describe how language content changes through adulthood.

46. Describe how language form changes through adulthood.

47. What are the three main parts of a neuron?

48. What is the definition of perseveration?

49. What are the four lobes of the brain?

50. Severity of aphasia is related to a number of factors. Name three.

51. Name five concomitant or accompanying deficits associated with aphasia and provide definitions.

52. Name the types of fluent aphasia.

53. Name the types of non-fluent aphasia.

54. Name and describe the types/factors related to ischemic stroke.

55. Name and describe the types/factors related to hemorrhagic stroke.

56. How do the patterns of recovery vary with the type of stroke?

57. Name four factors that increase the risk of stroke.

58. After acute care, an individual who has a stroke may require care in which settings?

Name three.

59. What is the overall goal of treatment for aphasia?

60. Name the common characteristics of RHD. 61. Name three affected areas of pragmatics in individuals with RHD. 62. Name four procedures that may be used in assessment with individuals with RHD. 63. Explain the following terms: edema, hypoxia, infarction, and hematoma.

64. TBI may affect what five cognitive domains?

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65. What are the two most commonly reported language symptoms in TBI? 66. What is the most disturbed language area in TBI? Describe the related deficits.

67. Discuss assessment considerations in TBI. 68. Those with TBI recover in a

fashion.

69. Communication disorders associated with cognitive impairment progress over time and include what four features?

70. What are the lifespan issues associated with Alzheimer disease?

71. What is the SLP‟s role in assessment of cognitive impairment?

72. What is the focus of intervention for communication in cognitive impairment?

73. How are cognitive training and cognitive stimulation as used in management of cognitive impairment different?

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(d) Chapter 7 Test Answer Key 1. D (see page 219, section titled “The Nervous System”) 2. A (see page 219, section titled “The Nervous System”) 3. C (see page 219, section titled “The Nervous System”) 4. D (see page 219, section titled “The Brain”) 5. A (see page 220, section titled “The Brain”) 6. D (see page 239, section titled “Cognitive Skills”) 7. B (see page 221, section titled “Language Processing”) 8. A (see page 221, section titled “Language Processing”) 9. B (see page 221, section titled “Language Processing”) 10. A (see page 222, section titled “Language Processing”) 11. C (see page 222, section titled “Language Processing”) 12. B (see page 223, section titled “Aphasia”) 13. A (see page 226, section titled “Fluent Aphasias”) 14. B (see page 228, section titled “Fluent Aphasias”) 15. B (see page 228, section titled “Fluent Aphasias”) 16. C (see page 228, section titled “Fluent Aphasias”) 17. A (see page 228, section titled “Non-fluent Aphasias”) 18. B (see page 228, section titled “Non-fluent Aphasias”) 19. C (see page 228, section titled “Non-fluent Aphasias”) 20. A (see page 229, section titled “Causes of Aphasia”) 21. C (see page 230, section titled “Causes of Aphasia”) 22. B (see page 243, section titled “Primary Progressive Aphasia”) 23. B (see page 233, section titled “Lifespan Issues”) 24. A (see page 233, section titled “Lifespan Issues”) 25. C (see page 234, section titled “Assessment for Aphasia”) 26. A (see page 235, section titled “Assessment for Aphasia”) 27. B (see page 238, section titled “Cognitive Skills”) 28. D (see page 242, section titled “Evidence-Based Practice) 29. C (see page 244, section titled “Right-Hemisphere Damage”) 30. A (see page 246, section titled “Characteristics”) 31. B (see page 246, section titled “Right-Hemisphere Damage”) 28 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

32. C (see page 247, section titled “Characteristics”) 33. A (see page 249, section titled “Intervention”) 34. B (see page 249, section titled “Intervention”) 35. C (see page 249, section titled “Intervention”) 36. A (see page 249, section titled “Traumatic Brain Injury”) 37. D (see page 250, section titled “Traumatic Brain Injury”) 38. C (see page 251, section titled “Characteristics”) 39. D (see page 251, section titled “Characteristics”) 40. D (see page 256, section titled “Intervention”) 41. D (see pages 256–257, section titled “Cognitive Impairment”) 42. C (see page 257, section titled “Cognitive Impairment”) 43. A (see page 257, section titled “Cognitive Impairment”) 44. Answers will vary, but should include some of the following points (see pages 217– 218, section titled “Use”): Adults are effective communicators and skilled conversationalists who use a variety of styles. Competent communicators sense their role and adjust language and speech accordingly. The number of communicative intentions increases gradually.

Changes in writing and reading abilities are not dramatic. Narratives improve into middle age and senior years, decreasing after the late 70s.

45. Answers will vary, but should include some of the following points (see page 218, section titled “Content”): Adults use between 30,000 and 60,000 words expressively. Specialized vocabularies develop for various aspects of life. Some words fade from the language and new words are added. Multiple definitions and figurative meanings are expanded. Typical older adults experience some deficits in accuracy and speed of word retrieval and naming. Older adults use more indefinite words. Accompanying deficits in working memory affect the ability to produce grammatically complex sentences.

46. Answers will vary, but should include some of the following points (see page 218, section titled “Form”): Adults continue to acquire prefixes, morphophonemic contrasts, and some irregular verbs. Conversations become more cohesive through more effective use of linguistic devices. In general, written language is more complex than spoken language.

Complex sentence production declines with advanced age, related to word retrieval.

Decline in oral/written language comprehension, understanding complex syntax, and inferencing.

47. Answers will vary, but should include the following information (see page 219, section titled The Nervous System”):

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Cell body, axon, dendrites 48. Answers will vary, but should include some of the following points (see page 232, section titled “Lifespan Issues”): Repetition of inappropriate responses.

49. Answers will vary, but should include the following information (see page 220, section titled “The Brain”): Frontal, temporal, parietal, and occipital 50. Answers will vary, but should include some of the following points (see page 224, section titled “Aphasia”): Cause, extent, location, and age of brain injury; age of the client; general health of the client 51. Answers will vary, but should include some of the following points (see pages 224– 225, section titled “Concomitant or Accompanying Deficits”): Hemiparesis: Weakness on one side of the body. Hemiplegia: Paralysis on one side of the body. Hemisensory impairment: A loss of the ability to perceive sensory information on one side of the body. Dysphagia: Difficulty chewing or swallowing.

Agnosia: Difficulty understanding incoming sensory information. Agrammatism: Omission of grammatical elements. Difficulty naming. Jargon: Meaningless or irrelevant speech with typical intonational patterns. Neologism: A novel word.

Paraphasia: Word substitutions found in clients who may talk fluently and grammatically.

52. Answers will vary, but should include the following information (see pages 226 and 228, section titled “Fluent Aphasias”): Wernicke‟s, anomic, conduction, transcortical sensory 53. Answers will vary, but should include the following information (see page 228, section titled “Non-fluent Aphasias”): Broca‟s, transcortical motor, global/mixed 54. Answers will vary, but should include some of the following points (see page 230, section titled “Causes of Aphasia”): Cerebral arteriosclerosis: Thickening of the walls of the cerebral arteries in which elasticity is lost or reduced, the walls become weakened, and blood flow is restricted. Embolism: Obstructed blood flow caused by blood clot, fatty materials, or air bubble. Thrombosis: Plaque buildup or blood clot formed on site and does not travel, causing blood flow to be restricted. Transient ischemic attack: Temporary condition with symptoms mirroring a stroke; blood flow to a portion of the brain is blocked or reduced, but then returns after a short interval.

55. Answers will vary, but should include some of the following points (see page 230, section titled “Causes of Aphasia”): Aneurysm: A saclike bulging in a weakened artery wall. Arteriovenous malformation: Poorly formed tangle of arteries and veins; malformed arterial walls may be weak 30 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

and give way under pressure.

56. Answers will vary, but should include some of the following points (see page 230, section titled “Causes of Aphasia”): Ischemic: Noticeable improvement with the first weeks, but slows after 3 months.

Hemorrhagic: Most rapid recovery is at the end of the first month and into the second.

57. Answers will vary, but should include some of the following points (see page 231, section titled “Lifespan Issues”): Smoking, poor diet, lack of exercise, alcohol use, high blood pressure, high cholesterol, diabetes, obesity, previous strokes, previous T IAs 58. Answers will vary, but should include some of the following points (see page 232, section titled “Lifespan Issues”): Rehabilitative hospitalization, outpatient rehabilitation, nursing home care 59. Answers will vary, but should include some of the following points (see page 237, section titled “Intervention”): To aid in the recovery of language and to provide strategies to compensate for persistent language deficits.

60. Answers will vary, but should include some of the following points (see page 245, section titled “Characteristics”): Neglect of information from the left side. Unrealistic denial of illness or limb involvement. Impaired judgment and self-monitoring. Lack of motivation. Inattention.

61. Answers will vary, but should include some of the following points (see page 247, section titled “Characteristics”): Topic maintenance, appreciation of the communication situation, determination of listener needs.

62. Answers will vary, but should include some of the following points (see page 248, section titled “Assessment”): Interviewing, observations, ratings of the client‟s behavior, testing of communication 63. Answers will vary, but should include some of the following points (see page 250, section titled “Traumatic Brain Injury”): Edema: Swelling due to increased fluid. Can lead to increased intracranial pressure.

Hypoxia: Oxygen deprivation. Infarction: Death of tissue deprived of blood supply.

Hematoma: Focal bleeding.

64. Answers will vary, but should include the following information (see page 250, section titled “Characteristics”): Orientation, memory, executive function, attention, reasoning/problem solving 65. Answers will vary, but should include the following information (see page 251, section titled “Characteristics”): 31 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Anomia and impaired comprehension 66. Answers will vary, but should include some of the following points (see page 251, section titled “Characteristics”): Pragmatics is the most disturbed language area in TBI. They may have an inability to inhibit behavior, demonstrate errors of judgment, have rambling/incoherent speech, poor turn-taking skills, poor affective language abilities, and inappropriate laughter or swearing.

67. Answers will vary, but should include some of the following points (see pages 253– 254, section titled “Assessment”): The SLP assesses communication, cognitive-communication functioning, and swallowing. Assessment must be ongoing and varies with each stage. Few comprehensive tools exist for assessment of language skills in individuals with TBI. Sampling is essential because pragmatic behavior varies across communication contexts. An informal procedure for assessing written language might describe microstructural and macrostructural difficulties.

68. Answers should include the following point (see page 254, section titled “Intervention”): Plateau 69. Answers will vary, but should include some of the following points (see page 258, section titled “Cognitive Impairment”): Anomia, comprehension deficits, production deficits, and the eventual inability to express oneself via speech and language.

70. Answers will vary, but should include some of the following points (see page 260, section titled “Lifespan Issues”): Often the person who will be afflicted with A D is unaware and/or ignores early signs.

At present, there are no cures, but some early drug therapies seem to lessen the effects. In the early stages, the individual experiences memory loss. As the disease progresses, memory loss increases and vocabulary decreases. In the most advanced stages, all intellectual functions including memory are severely impaired and almost all individuals reside in nursing homes.

71. Answers will vary, but should include some of the following points (see pages 260– 261, section titled “Assessment”): SLPs usually identify changes in language performance that may signal intellectual deterioration and aspects of behavior amenable to change.

72. Answers will vary, but should include some of the following points (see page 261, section titled “Intervention”): Intervention can help maintain the client at his or her highest level of performance and help others maximize the client‟s participation in conversation. Emphasize the use of intact cognitive abilities to compensate for deficient ones.

73. Answers will vary, but should include some of the following points (see page 262, 32 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

section titled “Intervention”): Cognitive training can be used to improve specific cognitive functions, such as attention, memory, and executive functions. Cognitive stimulation is less direct and is usually conducted in groups; it can be used to enhance cognitive and social functioning and might involve relaxation exercises or music therapy.

Article VIII. Chapter 8 Test Item File

Introduction to Communication Disorders A Lifespan Evidence-Based Perspective

Seventh Edition

Dr. Robert E. Owens, College of St. Rose Dr. Kimberly A. Farinella, Northern Arizona University

Prepared by

Dr. Sarah A. Dachtyl

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Section 8.01

Table of Contents

Chapter 8: Fluency Disorders

1

Learning Objective Quizzes

1

Application Exercises

11

Test Items

14

Test Answer Key

18

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Section 8.02 Chapter 8: Fluency Disorders (a) Chapter 8 Learning Objective Quizzes Learning Objective 8.1: Describe the differences between fluent speech and stuttering.

[Q1] There is an increase in disfluent speech beginning around age

.

1. 1 2. 2 [correct] 3. 3 4. 4 [Feedback for Answer Choice 1] There is an increase in disfluent speech beginning around age 2. Age 1 is too early.

[Feedback for Correct Answer 2] There is an increase in disfluent speech beginning around age 2.

[Feedback for Answer Choice 3] There is an increase in disfluent speech beginning around age 2. Age 3 is typically older than would be expected.

[Feedback for Answer Choice 4] There is an increase in disfluent speech beginning around age 2. Age 4 is typically older than would be expected.

[Q2] Ethan is a young boy who stutters. In children who stutter, repetitions are faster than repetitions produced by typically disfluent children.

1. 2 2. 3 [correct] 3. 4 4. 5 [Feedback for Answer Choice 1] In children who stutter, repetitions are 3 times faster than repetitions produced by typically disfluent children. Two times faster is not fast enough.

[Feedback for Correct Answer 2] In children who stutter, repetitions are 3 times faster than repetitions produced by typically disfluent children.

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times

[Feedback for Answer Choice 3] In children who stutter, repetitions are 3 times faster than repetitions produced by typically disfluent children. Four times faster is significantly faster than would be expected.

[Feedback for Answer Choice 4] In children who stutter, repetitions are 3 times faster than repetitions produced by typically disfluent children. Five times faster is significantly faster than would be expected.

[Q3] (more than one disfluency in a word) is/are common in young children who stutter and may indicate the onset of stuttering.

1. Clustered disfluencies [correct] 2. Cluttering 3. Secondary behaviors 4. Neurogenic disfluencies [Feedback for Correct Answer 1] Clustered disfluencies (more than one disfluency in a word) are common in young children who stutter and may indicate the onset of stuttering.

[Feedback for Answer Choice 2] Clustered disfluencies (more than one disfluency in a word) are common in young children who stutter and may indicate the onset of stuttering. Cluttering is a separate fluency disorder.

[Feedback for Answer Choice 3] Clustered disfluencies (more than one disfluency in a word) are common in young children who stutter and may indicate the onset of stuttering. Secondary behaviors may co-occur with stuttering but are not disfluencies.

[Feedback for Answer Choice 4] Clustered disfluencies (more than one disfluency in a word) are common in young children who stutter and may indicate the onset of stuttering. Neurogenic disfluencies have a different etiology than developmental stuttering.

Learning Objective 8.2: Outline and describe the onset and development of stuttering through the lifespan.

[Q1] In the older preschool years, may occur, and increased tension of the speech mechanism may begin to appear.

1. secondary behaviors 2 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

2. prolongations 3. repetitions 4. blocks [correct] [Feedback for Answer Choice 1] In the older preschool years, blocks may occur, and increased tension of the speech mechanism may begin to appear. Secondary behaviors may also occur but are not necessarily associated with increased tension of the speech mechanism.

[Feedback for Answer Choice 2] In the older preschool years, blocks may occur, and increased tension of the speech mechanism may begin to appear. Prolongations occur earlier.

[Feedback for Answer Choice 3] In the older preschool years, blocks may occur, and increased tension of the speech mechanism may begin to appear. Repetitions occur earlier.

[Feedback for Correct Answer 4] In the older preschool years, blocks may occur, and increased tension of the speech mechanism may begin to appear.

[Q2] Quinn uses

to avoid words on which he may stutter.

1. complex secondary behaviors 2. increased tension 3. circumlocution [correct] 4. increased pitch [Feedback for Answer Choice 1] Individuals who stutter may use circumlocution, not complex secondary behaviors, to avoid words on which they may stutter.

[Feedback for Answer Choice 2] Individuals who stutter may use circumlocution, not increased tension, to avoid words on which they may stutter.

[Feedback for Correct Answer 3] Individuals who stutter may use circumlocution to avoid words on which they may stutter.

[Feedback for Answer Choice 4] Individuals who stutter may use circumlocution, not increased pitch, to avoid words on which they may stutter.

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[Q3] The onset of stuttering may be sudden for as many as

of children.

1. 15% 2. 23% 3. 36% [correct] 4. 47% [Feedback for Answer Choice 1] The onset of stuttering may be sudden for as many as 36% of children. Fifteen percent is too low.

[Feedback for Answer Choice 2] The onset of stuttering may be sudden for as many as 36% of children. Twenty-three percent is too low.

[Feedback for Correct Answer 3] The onset of stuttering may be sudden for as many as 36% of children.

[Feedback for Answer Choice 4] The onset of stuttering may be sudden for as many as 36% of children. Forty-seven percent is too high.

Learning Objective 8.3: Describe the major etiological theories and conceptual models of stuttering.

[Q1] Findings of structural and functional differences in the brains of adults with chronic developmental stuttering may support the 1. theory of cerebral dominance. [correct] 2. semantogenic theory.

3. covert repair hypothesis.

4. demands and capacities model.

[Feedback for Correct Answer 1] Findings of structural and functional differences in the brains of adults with chronic developmental stuttering may support the theory of cerebral dominance. It does not support the semantogenic theory, which states that overly concerned parents react to the child‟s typical speech hesitations and repetitions with negative statements, making the child anxious about speaking, and fostering further hesitations and repetitions.

[Feedback for Answer Choice 2]

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Findings of structural and functional differences in the brains of adults with chronic developmental stuttering support the theory of cerebral dominance [Feedback for Answer Choice 3] Findings of structural and functional differences in the brains of adults with chronic developmental stuttering support the theory of cerebral dominance. It does not support the covert repair hypothesis, which assumes that stuttering is a reaction to some flaw in the speech production plan.

[Feedback for Answer Choice 4] Findings of structural and functional differences in the brains of adults with chronic developmental stuttering support the theory of cerebral dominance. It does not support the demands and capacities model, which asserts that stuttering develops when the environmental demands placed on a child to produce fluent speech exceed the child‟s physical and learned capacities.

[Q2] One theory for which there is contrary evidence proposes that overly concerned parents cause increased stuttering by negatively reacting to a child‟s normal speech hesitations and repetitions. This theory is called: 1. the covert repair hypothesis.

2. the theory of cerebral dominance.

3. the demands and capacities model.

4. the semantogenic theory. [correct] [Feedback for Answer Choice 1] One theory for which there is contrary evidence proposes that overly concerned parents cause increased stuttering by negatively reacting to a child‟s normal speech hesitations and repetitions; this theory is called the semantogenic theory, not the covert repair hypothesis.

[Feedback for Answer Choice 2] One theory for which there is contrary evidence proposes that overly concerned parents cause increased stuttering by negatively reacting to a child‟s normal speech hesitations and repetitions; this theory is called the semantogenic theory, not the theory of cerebral dominance.

[Feedback for Answer Choice 3] One theory for which there is contrary evidence proposes that overly concerned parents cause increased stuttering by negatively reacting to a child‟s normal speech hesitations and repetitions; this theory is called the semantogenic theory, not the demands and capacities model.

[Feedback for Correct Answer 4]

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One theory for which there is contrary evidence proposes that overly concerned parents cause increased stuttering by negatively reacting to a child‟s normal speech hesitations and repetitions; this theory is called the semantogenic theory.

[Q3] In the , there are three factors that cause moments of stuttering: a deficit in language processing, triggers, and modulating factors.

1. Packman and Attanasio model [correct] 2. multifactorial dynamic pathways model 3. demands and capacities model 4. covert repair hypothesis model [Feedback for Correct Answer 1] In the Packman and Attanasio model, there are three factors that cause moments of stuttering: a deficit in language processing, triggers, and modulating factors.

[Feedback for Answer Choice 2] In the Packman and Attanasio model, there are three factors that cause moments of stuttering: a deficit in language processing, triggers, and modulating factors. The multifactorial dynamic pathways model, attempts to describe the critical factors (genes, experience, environmental influences) contributing to the diagnosis of stuttering in children.

[Feedback for Answer Choice 3] In the Packman and Attanasio model, there are three factors that cause moments of stuttering: a deficit in language processing, triggers, and modulating factors. In the demands and capacities model, it is asserted that stuttering develops when the environmental demands placed on a child to produce fluent speech exceed the child‟s physical and learned capacities.

[Feedback for Answer Choice 4] In the Packman and Attanasio model, there are three factors that cause moments of stuttering: a deficit in language processing, triggers, and modulating factors. In the covert repair hypothesis, it is assumed that stuttering is a reaction to some flaw in the speech production plan.

Learning Objective 8.4: List and briefly describe the components of a comprehensive stuttering evaluation.

[Q1] The primary component of an evaluation for a child suspected of stuttering is: 1. standardized testing.

2. a detailed analysis of speech behaviors. [correct] 6 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

3. a record of secondary behaviors.

4. observation.

[Feedback for Answer Choice 1] The primary component of an evaluation for a child suspected of stuttering is a detailed analysis of speech behaviors. Standardized testing can be included but is not necessary.

[Feedback for Correct Answer 2] The primary component of an evaluation for a child suspected of stuttering is a detailed analysis of speech behaviors.

[Feedback for Answer Choice 3] The primary component of an evaluation for a child suspected of stuttering is a detailed analysis of speech behaviors. A record of secondary behaviors is important but not primary.

[Feedback for Answer Choice 4] The primary component of an evaluation for a child suspected of stuttering is a detailed analysis of speech behaviors. Observation is important but not primary.

[Q2] Kelly exhibits borderline stuttering. She does not have a family history of stuttering.

Which of the following is supported by the information in this chapter given her profile?

1. Immediate treatment should be intensive, up to five sessions per week.

2. Without immediate treatment, her stuttering will quickly worsen.

3. She may not need immediate treatment. [correct] 4. She is not a candidate for treatment.

[Feedback for Answer Choice 1] Children exhibiting borderline stuttering with no significant family history may not need immediate treatment. Rather, following these children and monitoring their disfluencies to ensure stuttering behaviors decrease during that first year may be all that is needed.

Immediate, intense treatment is not indicated in this case.

[Feedback for Answer Choice 2] Children exhibiting borderline stuttering with no significant family history may not need immediate treatment. Rather, following these children and monitoring their disfluencies to ensure stuttering behaviors decrease during that first year may be all that is needed.

There is no indication that a lack of immediate treatment would lead her stuttering to quickly worsen.

[Feedback for Correct Answer 3]

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Children exhibiting borderline stuttering with no significant family history may not need immediate treatment. Rather, following these children and monitoring their disfluencies to ensure stuttering behaviors decrease during that first year may be all that is needed.

[Feedback for Answer Choice 4] Children exhibiting borderline stuttering with no significant family history may not need immediate treatment. Rather, following these children and monitoring their disfluencies to ensure stuttering behaviors decrease during that first year may be all that is needed.

She is not immediately ruled out as a candidate for treatment.

[Q3] Franco is a 14-year-old whose stuttering is persistent. Which of the following is a risk factor for persistent stuttering?

1. Family history of language impairment 2. Low socioeconomic status 3. History of chronic otitis media 4. Being male [correct] [Feedback for Answer Choice 1] Being male is a risk factor for persistent stuttering; family history of language impairment is not.

[Feedback for Answer Choice 2] Being male is a risk factor for persistent stuttering; low socioeconomic status is not.

[Feedback for Answer Choice 3] Being male is a risk factor for persistent stuttering; history of chronic otitis media is not.

[Feedback for Correct Answer 4] Being male is a risk factor for persistent stuttering.

Learning Objective 8.5: Describe efficacious treatment approaches for children and adults who stutter.

[Q1] are viable for children who are just beginning to stutter and whose stuttering is mild.

1. Direct approaches 2. Fluency-shaping techniques 3. Stuttering modification techniques 4. Indirect approaches [correct] [Feedback for Answer Choice 1] 8 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Indirect approaches are viable for children who are just beginning to stutter and whose stuttering is mild. Direct approaches are not generally recommended in such cases.

[Feedback for Answer Choice 2] Indirect approaches are viable for children who are just beginning to stutter and whose stuttering is mild. Fluency-shaping techniques are not generally recommended in such cases.

[Feedback for Answer Choice 3] Indirect approaches are viable for children who are just beginning to stutter and whose stuttering is mild. Stuttering modification techniques are not generally recommended in such cases.

[Feedback for Correct Answer 4] Indirect approaches are viable for children who are just beginning to stutter and whose stuttering is mild. [Q2] Addressing related to stuttering and effectively managing negative reactions from others are integral to the direct therapeutic process.

1. negative feelings and thoughts [correct] 2. speech timing patterns 3. self-monitoring 4. verbal contingencies [Feedback for Correct Answer 1] Addressing negative feelings and thoughts related to stuttering and effectively managing negative reactions from others are integral to the direct therapeutic process.

[Feedback for Answer Choice 2] Addressing negative feelings and thoughts related to stuttering and effectively managing negative reactions from others, rather than addressing speech timing patterns, are integral to the direct therapeutic process.

[Feedback for Answer Choice 3] Addressing negative feelings and thoughts related to stuttering and effectively managing negative reactions from others, rather than addressing self-monitoring, are integral to the direct therapeutic process.

[Feedback for Answer Choice 4] Addressing negative feelings and thoughts related to stuttering and effectively managing negative reactions from others, rather than addressing verbal contingencies, are integral to the direct therapeutic process.

[Q3]

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Jill, a young adult who stutters, underwent to help restructure negative thought patterns by eliminating atypical behaviors and replacing them with more positive patterns of behavior.

1. stuttering modification 2. cognitive behavioral therapy [correct] 3. the Lidcombe method 4. delayed auditory feedback [Feedback for Answer Choice 1] Cognitive behavioral therapy helps restructure negative thought patterns by eliminating atypical behaviors and replacing them with more positive patterns of behavior.

Stuttering modification techniques involve changing only the stuttering behaviors.

[Feedback for Correct Answer 2] Cognitive behavioral therapy helps restructure negative thought patterns by eliminating atypical behaviors and replacing them with more positive patterns of behavior.

[Feedback for Answer Choice 3] Cognitive behavioral therapy helps restructure negative thought patterns by eliminating atypical behaviors and replacing them with more positive patterns of behavior. In the Lidcombe method, there are parent-administered verbal contingencies for stuttering and stutter-free speech.

[Feedback for Answer Choice 4] Cognitive behavioral therapy helps restructure negative thought patterns by eliminating atypical behaviors and replacing them with more positive patterns of behavior. In delayed auditory feedback, a speaker hears their own speech after an instrumental delay of some finite period of time, such as 250 to 500 milliseconds.

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(b) Chapter 8 Application Exercises Application Exercise 8.1: Describe stuttering and its effects.

Learning Objective 8.1: Describe the differences between fluent speech and stuttering.

Reference: Case Study: Dylan (see pages 268 and 271) [Q1] Use Case Study: Dylan (see pages 268 and 271) to answer the following question: Based on this case study, what types of secondary and avoidance behaviors did Dylan exhibit at the time of his evaluation during graduate school?

[Q1 Model Response] Dylan‟s secondary behaviors included head nodding and slapping his leg. Dylan was also noted to avoid certain words, including his name. He had a difficult time starting conversations with people because of his stuttering.

[Q2] Use Case Study: Dylan (see pages 268 and 271) to answer the following question: What types of stuttering behaviors did Dylan‟s parents notice when he was young?

[Q2 Model Response] Dylan‟s parents noticed he would often repeat the first sound in words when beginning to speak. They also noticed occasional sound prolongations.

[Q3] Use Case Study: Dylan (see pages 268 and 271) to answer the following question: What types of emotional symptoms did Dylan‟s parents notice when he was young that were related to his stuttering?

[Q3 Model Response] Dylan sometimes became frustrated and stopped talking in the middle of a sentence without finishing.

Application Exercise 8.2: Describe the development and progression of stuttering.

Learning Objective 8.2: Outline and describe the onset and development of stuttering through the lifespan.

Reference: Table 8.2 (see page 274) [Q1] Use Table 8.2 (see page 274) to answer the following question:

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Based on the summary of the development and progression of stuttering in Box 8.2, describe the main features of the younger preschool/borderline stuttering years.

[Q1 Model Response] Stuttering is highly variable. More than 6–10 disfluencies per 100 words. More than one or two units in repetitions. Higher proportion of part-word and monosyllabic whole-word repetitions and prolongations. The child seems unaware of stuttering and rarely expresses frustration. Few, if any, secondary behaviors exist.

[Q2] Use Table 8.2 (see page 274) to answer the following question: Based on the summary of the development and progression of stuttering in Box 8.2, describe the main features of the school-age/intermediate stuttering years.

[Q2 Model Response] Fear of stuttering and attempts to avoid certain speaking situations are common.

Certain words are regarded as more difficult than others. Circumlocutions and word substitutions are frequent. Blocks with increased muscular tension become more frequent, although repetitions and prolongations with increased pitch are still common.

Secondary behaviors to avoid or escape stuttering become more complex.

[Q3] Use Table 8.2 (see page 274) to answer the following question: Based on the summary of the development and progression of stuttering in Box 8.2, describe the main features of the adolescent and adulthood/advanced stuttering years.

[Q3 Model Response] Stuttering is at its apex of development. There is fearful anticipation of stuttering.

Longer, more tense blocks accompanied by lip, tongue, or jaw tremors mixed with repetitions and prolongations are frequent. Certain sounds, words, and speaking situations are carefully avoided. Circumlocutions, word substitutions, and interjections are used extensively as avoidance strategies.

Application Exercise 8.3: Describe a stuttering evaluation.

Learning Objective 8.4: List and briefly describe the components of a comprehensive stuttering evaluation.

Reference: Case Study: Dylan (see page 280) [Q1] Use Case Study: Dylan (see page 280) to answer the following question: Based on this case study, what information about Dylan‟s stuttering was gathered via the Stuttering Severity Instrument–4 (SSI–4)?

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[Q1 Model Response] Dylan‟s percentage of syllables stuttered on both a reading task and a speaking task were determined. The duration of stuttering was assessed by measuring the length of the three longest stuttering moments and calculating a mean duration. Physical tension and secondary behaviors were observed and counted to derive a “Physical Concomitants” score.

[Q2] Use Case Study: Dylan (see page 280) to answer the following question: Based on this case study, what information about Dylan‟s stuttering was gathered via nonstandardized measures?

[Q2 Model Response] The percentage of syllables stuttered was calculated for speaking tasks that Dylan determined were either low stress or high stress and for speaking situations outside the clinical setting.

[Q3] Use Case Study: Dylan (see page 280) to answer the following question: What were the results of Dylan‟s stuttering evaluation?

[Q3 Model Response] The SSI–4 total overall score, as well as disfluent calculations on all other speaking tasks, indicated Dylan had a severe stuttering impairment.

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(c) Chapter 8 Test Items 1. The lifetime incidence of stuttering is as high as a. 8%. b. 12%. c. 20%. d. 25%.

2.

is the most common form of stuttering; it begins in the preschool years. a. Psychogenic stuttering b. Developmental stuttering c. Acquired stuttering d. Neurogenic stuttering

3.

is typically associated with neurological disease or trauma. a. Psychogenic stuttering b. Developmental stuttering c. Neurogenic stuttering d. Acquired stuttering

4. The prevalence of stuttering is over

for preschool children.

a. 2% b. 4% c. 6% d. 8% 5. Onset of developmental stuttering is between what ages? a. 1 and 3 b. 2 and 5 c. 6 and 10 d. 8 and 15 6. In the younger preschool age group of the developmental framework of stuttering, which of the following is true? a. Most children are unaware or are not bothered by disfluencies b. Stuttering is essentially chronic or habitual c. There is evidence of fear, embarrassment, or avoidance d. Stuttered words may have associated audible vocal tension and rising pitch 14 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

7. In the older teens and adults age group of the developmental framework of stuttering, which of the following is true? a. Most children are unaware or are not bothered by disfluencies b. Stuttering is essentially chronic or habitual c. There is evidence of fear, embarrassment, or avoidance d. The individual has developed a self-concept as a person who stutters 8. The for stuttering.

theory of stuttering proposes an actual physical cause

a. behavioral b. psychological c. organic d. somatogenic 9. The theory of stuttering asserts that stuttering is a learned response to conditions external to the individual. a. behavioral b. psychological c. organic d. somatogenic 10. More than

repetitions of a sound or word is considered stuttering.

a. 2 b. 4 c. 6 d. 8 11. More than 10 disfluencies per child has a fluency problem.

spoken words may indicate that the

a. 15 b. 50 c. 100 d. 200 12. Standardized tests a. exist but are not effective for assessment of stuttering. b. may be used. c. do not exist. d. are normed only for children ages 3–18.

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13. If stuttering does not decrease within after initiating indirect treatment for stuttering, direct treatment may be recommended. a. 2 weeks b. 6 weeks c. 10 weeks d. 3 months 14.

is a fluency shaping technique that aims to reduce speech rate; the slowing of speech rate is accompanied by a substantial decrease in stuttering. a. Light articulatory contacts b. Prolonged speech c. Pausing/phrasing d. Response-contingent stimulation

15. When does fear and avoidance of stuttering begin to emerge? a. Younger preschool years b. Older preschool years c. School-age d. Adulthood 16.

is a fluency shaping technique that reduces speech rate and physical tension before and during occurrences of stuttering, promoting smooth speech. a. Prolonged speech b. Light articulatory contacts c. Pausing/phrasing d. Response-contingent stimulation

17. The assumes that stuttering is a reaction to some flaw in the speech production plan. a. Organic theory b. demands and capacities model c. semantogenic theory d. covert repair hypothesis 18. In , the individual modifies the stuttered word during the actual occurrence of stuttering. a. cancellation phase b. pull-out phase 16 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

c. preparatory sets d. response contingent timeout 19. In , the individual prepares to use slow motion speech strategies in anticipation of stuttering. a. cancellation phase b. pull-out phase c. preparatory sets d. response contingent timeout 20. In , the individual completes the stuttered word and then pauses deliberately for a minimum of 3 seconds. a. cancellation phase b. pull-out phase c. preparatory sets d. response contingent timeout 21. Stuttering intervention across all age groups results in an average improvement for about of all cases, with preschool-age children improving more quickly and easily than people who have a longer history with stuttering. a. 30% b. 50% c. 70% d. 90% 22. Describe and give examples of normal disfluencies.

23. Describe and give examples of stuttering disfluencies.

24. Name four secondary characteristics that can accompany speech disfluencies.

25. Name and explain the two current conceptual models of stuttering.

26. Describe the concept of “borderline stuttering.”

27. Describe indirect approaches for stuttering therapy and the target population.

28. Describe direct approaches for stuttering therapy and the target population.

29. Describe the Lidcombe program for stuttering treatment.

30. Name four factors on which the selection of intervention techniques depend.

31. What is the efficacy of stuttering intervention with preschool-age children?

32. Describe the effect of stuttering on an individual in the workplace.

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(d) Chapter 8 Test Answer Key 1. A (see page 269, Introduction) 2. B (see page 273, section titled “The Onset and Development of Stuttering Through the Lifespan”) 3. C (see page 273, section titled “The Onset and Development of Stuttering Through the Lifespan”) 4. A (see page 269, Introduction) 5. B (see page 273, section titled “The Onset and Development of Stuttering Through the Lifespan”) 6. A (see page 275, section titled “The Onset and Development of Stuttering Through the Lifespan”) 7. D (see page 276, section titled “The Onset and Development of Stuttering Through the Lifespan) 8. C (see page 277, section titled “Organic Theory”) 9. A (see page 277, section titled “Behavioral Theory”) 10. A (see page 272, section titled “Stuttering”) 11. C (see page 271, section titled “Stuttering”) 12. B (see page 279, section titled “Evaluation of Stuttering”) 13. B (see page 282, section titled “Indirect Treatment”) 14. B (see page 284, section titled “Fluency-Shaping Techniques”) 15. C (see page 275, section titled “The Onset and Development of Stuttering Through the Lifespan”) 16. B (see page 284, section titled “Fluency-Shaping Techniques”) 17. D (see page 278, section titled “Language and Stuttering”) 18. B (see page 286, section titled “Stuttering Modification Techniques”) 19. C (see page 286, section titled “Stuttering Modification Techniques”) 20. A (see page 285, section titled “Stuttering Modification Techniques”) 21. C (see page 289, section titled “Efficacy of Intervention with Adolescents and Adults”) 22. Answers may vary, but should include the following points (see page 270, section titled “Typical Disfluencies”): At age 2, whole-word repetitions, interjections, and syllable repetitions are common.

Revisions are the dominant disfluency type when the child reaches 3 years. Typical disfluencies persist throughout the course of one‟s life. Fluent speakers may repeat whole multisyllabic words, interject a word or phrase, repeat phrases, or revise sentences.

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23. Answers may vary, but should include the following points (see page 271, section titled “Stuttering”): Stuttering or stuttered speech involves certain core behaviors, including repetitions of sounds, syllables, or one-syllable words, prolongations of sounds, or blocks, where an inappropriate stop in the flow of air or voice occurs during speech production.

24. Answers may vary, but should include the following points (see page 273, section titled “Stuttering”): Eye blinking; facial grimacing; exaggerated movements of the head, shoulders, and arms; interjected speech fragments.

25. Answers may vary, but should include the following points (see pages 278–279, section titled “Current Conceptual Models of Stuttering”): The Packman and Attanasio three-factor model suggests that there are three factors that cause moments of stuttering: a deficit in the neural processing of language and inherent instability of the speech production system; triggers, or certain features of spoken language that are associated with greater speech motor demands that negatively affect an already unstable speech production system; and modulating factors, such as physiological arousal in an individual that can alter the threshold at which a stuttering moment occurs. The multifactorial dynamic pathways theory attempts to describe critical factors (genes, experience, environmental influences) contributing to the diagnosis of stuttering in children. It focuses on the interaction of these factors with the developing systems over time that lead to recovery from stuttering for most children.

26. Answers may vary, but should include the following points (see page 275, section titled “The Onset and Development of Stuttering Through the Lifespan”): Periods of stuttering are followed by periods of relative fluency.

27. Answers may vary, but should include the following points (see page 282, section titled “Indirect Treatment”): Focus on the child, the child‟s caregivers, and the child‟s environment. The S LP shares information and teaches parents to provide a slow, relaxed speech model for the child. Play-oriented activities that encourage slow and relaxed speech are a central component. There is no explicit discussion about the child‟s fluent or stuttering speaking behaviors. The goal is to facilitate fluency through environmental manipulation and is often effective for younger preschool children over a period of 1– 2 months.

28. Answers may vary, but should include the following points (see page 283, section titled “Direct Treatment”): Involve explicit and direct attempts to modify the child‟s speech and speech-related behaviors. Children are taught to identify “hard” and “easy” speech produce by the S LP first, and then in their own speech. Then the SLP teaches strategies to increase easy speech and change from hard to easy speech when required.

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29. Answers may vary, but should include the following points (see page 285, section titled “Fluency-Shaping Techniques”): The Lidcombe program involves parent-administered verbal contingencies for stutter-free speech and stuttering, as well as requests for self-correction.

30. Answers may vary, but should include the following points (see page 287, section titled “Selecting Intervention Techniques”): Age, severity, motivation, and specific needs of the client.

31. Answers may vary, but should include the following points (see pages 288–289, section titled “Efficacy of Intervention with Preschool-Age Children”): Indirect and direct treatment approaches have both been found to be effective and might be more effective when combined. Those in a parent-conducted program maintained their fluent speech in long-term clinical follow-up studies.

32. Answers may vary, but should include the following points (see pages 289–290, section titled “The Effects of Stuttering through the Lifespan”): Stuttering can have a negative impact in the workplace and is a vocationally disabling condition because employers view it as a disorder that decreases employability and opportunities for promotion.

Article IX. Chapter 9 Test Item File

Introduction to Communication Disorders A Lifespan Evidence-Based Perspective

Seventh Edition 20 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Dr. Robert E. Owens, College of St. Rose Dr. Kimberly A. Farinella, Northern Arizona University

Prepared by

Dr. Sarah A. Dachtyl

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Section 9.01

Table of Contents

Chapter 9: Voice and Resonance Disorders

1

Learning Objective Quizzes

1

Application Exercises

10

Test Items

13

Test Answer Key

19

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Section 9.02 Chapter 9: Voice and Resonance Disorders (a) Chapter 9 Learning Objective Quizzes Learning Objective 9.1: Explain the normal processes of phonation and resonance.

[Q1] The major determinant of vocal intensity is 1. vocal fold tension.

2. alveolar pressure. [correct] 3. vocal fold length.

4. velopharyngeal function.

[Feedback for Answer Choice 1] Changes in vocal intensity require the vocal folds to stay together longer, but alveolar pressure is the major determinant of vocal intensity. Vocal fold tension is not the major determinant of vocal intensity.

[Feedback for Correct Answer 2] Changes in vocal intensity require the vocal folds to stay together longer, but alveolar pressure is the major determinant of vocal intensity.

[Feedback for Answer Choice 3] Changes in vocal intensity require the vocal folds to stay together longer, but alveolar pressure is the major determinant of vocal intensity. Vocal fold length is not the major determinant of vocal intensity.

[Feedback for Answer Choice 4] Changes in vocal intensity require the vocal folds to stay together longer, but alveolar pressure is the major determinant of vocal intensity. Velopharyngeal function is not the major determinant of vocal intensity.

[Q2] Age-related changes to laryngeal muscle due to for increased fundamental frequency in older men.

may be responsible

1. atrophy [correct] 2. calcification 3. edema 4. ossification [Feedback for Correct Answer 1]

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For men, age-related changes to laryngeal muscle due to atrophy may be responsible for the increased fundamental frequency in older men.

[Feedback for Answer Choice 2] For men, age-related changes to laryngeal muscle due to atrophy may be responsible for the increased fundamental frequency in older men. Muscles cannot calcify.

[Feedback for Answer Choice 3] For men, age-related changes to laryngeal muscle due to atrophy may be responsible for the increased fundamental frequency in older men. Menopause and hormonerelated factors causing increased edema may be responsible for the change in women (lowered fundamental frequency).

[Feedback for Answer Choice 4] For men, age-related changes to laryngeal muscle due to atrophy may be responsible for the increased fundamental frequency in older men. Muscles cannot ossify.

[Q3] From young adulthood through advanced age, production remains intact and unchanged.

during speech

1. pulmonary function 2. movement of laryngeal structures 3. velopharyngeal function [correct] 4. pitch range [Feedback for Answer Choice 1] From young adulthood through advanced age, velopharyngeal function during speech production remains intact and unchanged. Pulmonary function does change with advanced age.

[Feedback for Answer Choice 2] From young adulthood through advanced age, velopharyngeal function during speech production remains intact and unchanged. Movement of laryngeal structures is reduced in older adults.

[Feedback for Correct Answer 3] From young adulthood through advanced age, velopharyngeal function during speech production remains intact and unchanged.

[Feedback for Answer Choice 4] From young adulthood through advanced age, velopharyngeal function during speech production remains intact and unchanged. Pitch range is reduced in older adults.

Learning Objective 9.2: Briefly describe voice and resonance disorders and describe the classification system for voice disorders.

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[Q1] and case history are initial benchmarks in differential diagnosis for a voice evaluation.

1. Reason for referral 2. Physical examination 3. Videostroboscopy 4. Perceptual signs [correct] [Feedback for Answer Choice 1] Perceptual signs (rather than reason for referral) and case history are initial benchmarks in differential diagnosis for voice evaluations.

[Feedback for Answer Choice 2] Perceptual signs (rather than a physical examination) and case history are initial benchmarks in differential diagnosis for voice evaluations.

[Feedback for Answer Choice 3] Perceptual signs (rather than videostroboscopy) and case history are initial benchmarks in differential diagnosis for voice evaluations.

[Feedback for Correct Answer 4] Perceptual signs and case history are initial benchmarks in differential diagnosis for voice evaluations.

[Q2] Ms. Clanahan‟s vocal folds are inflamed. The cause was determined to be vocal abuse.

The most likely diagnosis is: 1. laryngitis. [correct] 2. vocal nodules.

3. contact ulcers.

4. papilloma.

[Feedback for Correct Answer 1] Laryngitis results in inflammation of the vocal folds that can result from exposure to noxious agents, allergies, gastroesophageal reflux disease, or vocal abuse. Acute laryngitis is temporary swelling that can result in hoarseness, lowered pitch, and intermittent voice breaks.

[Feedback for Answer Choice 2] Laryngitis results in inflammation of the vocal folds that can result from exposure to noxious agents, allergies, gastroesophageal reflux disease, or vocal abuse. Acute laryngitis is temporary swelling that can result in hoarseness, lowered pitch, and 3 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

intermittent voice breaks. Vocal nodules are localized growths at the point of maximal contact during vocal fold vibration.

[Feedback for Answer Choice 3] Laryngitis results in inflammation of the vocal folds that can result from exposure to noxious agents, allergies, gastroesophageal reflux disease, or vocal abuse. Acute laryngitis is temporary swelling that can result in hoarseness, lowered pitch, and intermittent voice breaks. Contact ulcers are small, reddened ulcerations on the posterior surface of the vocal folds in the region of the arytenoid cartilages.

[Feedback for Answer Choice 4] Laryngitis results in inflammation of the vocal folds that can result from exposure to noxious agents, allergies, gastroesophageal reflux disease, or vocal abuse. Acute laryngitis is temporary swelling that can result in hoarseness, lowered pitch, and intermittent voice breaks. Laryngeal papilloma are small wart-like growths of the vocal folds and interior of the larynx.

[Q3] The

supplies most of the muscles of phonation.

1. superior laryngeal nerve 2. pharyngeal branch of the vagus nerve 3. recurrent laryngeal nerve [correct] 4. internal laryngeal branch of the vagus nerve [Feedback for Answer Choice 1] Unilateral and bilateral vocal fold paralysis result from damage to cranial nerve (C N) X (vagus). The recurrent laryngeal nerve supplies most of the laryngeal muscles for phonation.

[Feedback for Answer Choice 2] Unilateral and bilateral vocal fold paralysis result from damage to cranial nerve (C N) X (vagus). The recurrent laryngeal nerve supplies most of the laryngeal muscles for phonation.

[Feedback for Correct Answer 3] Unilateral and bilateral vocal fold paralysis result from damage to cranial nerve (C N) X (vagus). The recurrent laryngeal nerve supplies most of the laryngeal muscles for phonation.

[Feedback for Answer Choice 4] Unilateral and bilateral vocal fold paralysis result from damage to cranial nerve (C N) X (vagus). The recurrent laryngeal nerve supplies most of the laryngeal muscles for phonation.

[Q4] 4 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

can result from misuse, abuse, or overuse of the voice or psychological or stress factors, without causing physical changes to the larynx.

1. Structural abnormalities 2. Functional voice disorders [correct] 3. Neurologic voice disorders 4. Organic voice disorders [Feedback for Answer Choice 1] Functional voice disorders can result from misuse, abuse, or overuse of the voice or psychological or stress factors, without causing physical changes to the larynx.

Structural abnormalities of the laryngeal mechanism result in disordered voice.

[Feedback for Correct Answer 2] Functional voice disorders can result from misuse, abuse, or overuse of the voice or psychological or stress factors, without causing physical changes to the larynx.

[Feedback for Answer Choice 3] Functional voice disorders can result from misuse, abuse, or overuse of the voice or psychological or stress factors, without causing physical changes to the larynx. In neurologic voice disorders, there is damage in the CNS or PNS that causes a voice disorder.

[Feedback for Answer Choice 4] Functional voice disorders can result from misuse, abuse, or overuse of the voice or psychological or stress factors, without causing physical changes to the larynx. In organic voice disorders, there is an underlying physical or neurological basis.

Learning Objective 9.3: Describe the primary components of a voice and resonance evaluation.

[Q1] Mrs. Kahale underwent imaging of her vocal folds due to voice changes she had been experiencing over the last 6 months. During this test, a flashing light was used to create the illusion of slow motion vocal fold vibration. What is this called?

1. Ultrasonography 2. Videofluoroscopy 3. Endoscopy 4. Videostroboscopy [correct] [Feedback for Answer Choice 1] Imaging the rapid movements of the vocal folds during vibration requires the use of a flashing strobe light that creates the illusion of the vocal folds vibrating in slow motion, called videostroboscopy, rather than ultrasonography.

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[Feedback for Answer Choice 2] Imaging the rapid movements of the vocal folds during vibration requires the use of a flashing strobe light that creates the illusion of the vocal folds vibrating in slow motion, called videostroboscopy. In muti-view videofluoroscopy, a motion picture X-ray is recorded on DVD, which permits imaging of velopharyngeal function from three different perspectives.

[Feedback for Answer Choice 3] Imaging the rapid movements of the vocal folds during vibration requires the use of a flashing strobe light that creates the illusion of the vocal folds vibrating in slow motion, called videostroboscopy. Direct observation of laryngeal structures can be achieved with an endoscope, which is a camera lens coupled to a light source.

[Feedback for Correct Answer 4] Imaging the rapid movements of the vocal folds during vibration requires the use of a flashing strobe light that creates the illusion of the vocal folds vibrating in slow motion, called videostroboscopy.

[Q2] A comprehensive evaluation is necessary because abnormalities of can affect the perception of voice quality or can lead to hyperfunction of the voice as a compensatory response.

1. resonance [correct] 2. phonology 3. articulation 4. loudness [Feedback for Correct Answer 1] Perceptual judgments of resonance must also be made since abnormalities of resonance can affect the perception of voice quality or can lead to hyperfunction of the voice as a compensatory response.

[Feedback for Answer Choice 2] Perceptual judgments of resonance must also be made since abnormalities of resonance can affect the perception of voice quality or can lead to hyperfunction of the voice as a compensatory response. Abnormalities of phonology do not lead to hyperfunction.

[Feedback for Answer Choice 3] Perceptual judgments of resonance must also be made since abnormalities of resonance can affect the perception of voice quality or can lead to hyperfunction of the voice as a compensatory response. Abnormalities of articulation do not lead to hyperfunction.

[Feedback for Answer Choice 4] 6 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Perceptual judgments of resonance must also be made since abnormalities of resonance can affect the perception of voice quality or can lead to hyperfunction of the voice as a compensatory response. Abnormalities of loudness do not lead to hyperfunction as a compensatory response; excessive loudness may be due to hyperfunction in and of itself.

[Q3] of/for resonance is the “gold standard” when it comes to evaluation.

1. Use of a nasometer 2. Auditory-perceptual evaluation [correct] 3. Videoendoscopy 4. Multi-view videofluoroscopy [Feedback for Answer Choice 1] Auditory-perceptual evaluation of resonance is still the “gold standard.” A nasometer may be used to supplement the evaluation.

[Feedback for Correct Answer 2] Auditory-perceptual evaluation of resonance is still the “gold standard.”

[Feedback for Answer Choice 3] Auditory-perceptual evaluation of resonance is still the “gold standard.” Videoendoscopy may be used to supplement the evaluation.

[Feedback for Answer Choice 4] Auditory-perceptual evaluation of resonance is still the “gold standard.” Multi-view videofluoroscopy may be used to supplement the evaluation.

Learning Objective 9.4: Describe the major goals of voice and resonance treatment and effective voice and resonance treatment approaches and techniques.

[Q1] Konstantin was born with a cleft palate. He is at high risk for 1. monopitch voice quality.

2. breathy voice quality.

3. disordered articulation. [correct] 4. language disorder.

[Feedback for Answer Choice 1]

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Direct intervention for speech sound development should begin prior to the first palatal surgery because those with clefts are also at high risk for disordered articulation, rather than monopitch voice quality.

[Feedback for Answer Choice 2] Direct intervention for speech sound development should begin prior to the first palatal surgery because those with clefts are also at high risk for disordered articulation, rather than breathy voice quality.

[Feedback for Correct Answer 3] Direct intervention for speech sound development should begin prior to the first palatal surgery because those with clefts are also at high risk for disordered articulation.

[Feedback for Answer Choice 4] Direct intervention for speech sound development should begin prior to the first palatal surgery because those with clefts are also at high risk for disordered articulation, rather than language disorder.

[Q2] Mr. Muller experienced unilateral vocal fold paralysis. Which surgery did he undergo to improve his voice?

1. Botulinum toxin injections 2. Injection pharyngoplasty 3. Medialization laryngoplasty [correct] 4. Palatal lift [Feedback for Answer Choice 1] Medialization laryngoplasty (or type I thyroplasty) is a surgical procedure that may be used for unilateral vocal fold paresis or paralysis. Botox injections into laryngeal muscles is the standard of care for treating spasmodic dysphonia.

[Feedback for Answer Choice 2] Medialization laryngoplasty (or type I thyroplasty) is a surgical procedure that may be used for unilateral vocal fold paresis or paralysis. Injection pharyngoplasty is a procedure for resonance abnormalities.

[Feedback for Correct Answer 3] Medialization laryngoplasty (or type I thyroplasty) is a surgical procedure that may be used for unilateral vocal fold paresis or paralysis.

[Feedback for Answer Choice 4] Medialization laryngoplasty (or type I thyroplasty) is a surgical procedure that may be used for unilateral vocal fold paresis or paralysis. A palatal lift is a prosthetic used to manage an immobile velum.

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[Q3] It is necessary to shift both voice fundamental frequency and to be perceived as the opposite gender.

1. resonant formant frequencies [correct] 2. resonance 3. intensity 4. articulation [Feedback for Correct Answer 1] It is necessary to shift both voice fundamental frequency and resonant formant frequencies for an individual to be perceived as the opposite gender.

[Feedback for Answer Choice 2] It is necessary to shift both voice fundamental frequency and resonant formant frequencies (rather than resonance) for an individual to be perceived as the opposite gender.

[Feedback for Answer Choice 3] It is necessary to shift both voice fundamental frequency and resonant formant frequencies (rather than intensity) for an individual to be perceived as the opposite gender.

[Feedback for Answer Choice 4] It is necessary to shift both voice fundamental frequency and resonant formant frequencies (rather than articulation) for an individual to be perceived as the opposite gender.

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(b) Chapter 9 Application Exercises Application Exercise 9.1: Describe voice characteristics associated with structural abnormalities.

Learning Objective 9.2: Briefly describe voice and resonance disorders and describe the classification system for voice disorders.

Reference: Table 9.2 (see page 306) [Q1] Use Table 9.2 (see page 306) to answer the following question: Given the information in Table 9.2 (dysphonic voice characteristics associated with structural abnormalities), describe the voice characteristics of vocal nodules and vocal polyps.

[Q1 Model Response] Vocal nodules: Hoarseness and breathiness. Vocal polyps: Hoarseness, breathiness, sudden voice breaks, and diplophonia.

[Q2] Use Table 9.2 (see page 306) to answer the following question: Given the information in Table 9.2 (dysphonic voice characteristics associated with structural abnormalities), describe the voice characteristics of laryngeal cancer and contact ulcers/granulomas.

[Q2 Model Response] Laryngeal cancer: Persistent hoarseness. Contact ulcers/granulomas: Hoarseness and breathiness.

[Q3] Use Table 9.2 (see page 306) to answer the following question: Given the information in Table 9.2 (dysphonic voice characteristics associated with structural abnormalities), describe the voice characteristics of papilloma and webs.

[Q3 Model Response] Papilloma: Hoarseness and inspiratory stridor. Webs: High-pitched hoarseness, possible airway obstruction, and inspiratory stridor.

Application Exercise 9.2: Describe a voice and resonance evaluation.

Learning Objective 9.2: Describe the primary components of a voice and resonance evaluation.

Reference: Case Study: Blake (pages 310 and 314) 10 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

[Q1] Use Case Study: Blake (pages 310 and 314) to answer the following question: Given the information in the case study, what were Blake‟s videostroboscopic evaluation results?

[Q1 Model Response] Videostroboscopic results indicated the left vocal fold appearing shorter and fixed in the paramedian position. The left vocal fold was also reduced in tone and fluttered during phonation, contributing to asymmetrical vocal fold vibration. A small posterior opening during phonation was observed. The right vocal fold was normal in mobility.

[Q2] Use Case Study: Blake (pages 310 and 314) to answer the following question: What did dynamic assessment reveal for Blake?

[Q2 Model Response] Dynamic assessment revealed that, with increased vocal effort, Blake could achieve increased glottal closure and glottal closure duration. In other words, with high effort and a louder voice, Blake could achieve adequate vocal fold closure during voice despite having a weakened left vocal fold.

[Q3] Use Case Study: Blake (pages 310 and 314) to answer the following question: What did nasoendoscopic images reveal for Blake?

[Q3 Model Response] Nasoendoscopic images revealed evidence of previous surgical repair of the soft palate.

When repetition and modeling were provided, Blake was able to achieve complete closure of the velopharyngeal port for all pressure sounds in words during sentence tasks, thereby achieving typical resonance without hypernasality or nasal emission. The ENT‟s diagnosis included left unilateral vocal fold paralysis and normal structure for velopharyngeal closure with inconsistent, impaired function during connected speech.

Application Exercise 9.3: Describe treatment for voice and resonance.

Learning Objective 9.4: Describe the major goals of voice and resonance treatment and effective voice and resonance treatment approaches and techniques.

Reference: Case Study: Blake (see page 323) [Q1] Use Case Study: Blake (see page 323) to answer the following question: Given the case study information, what treatment stimuli were included in Blake‟s speech treatment?

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[Q1 Model Response] Bake felt that participating in group presentation assignments would motivate him to work hard during speech therapy sessions, so treatment stimuli included scripts that Blake was working on for his first-quarter group presentation in his world history class.

[Q2] Use Case Study: Blake (see page 323) to answer the following question: What was included in Blake‟s home program?

[Q2 Model Response] A daily home practice program of vocal function exercises (e.g., maximum phonation tasks; pitch glides from lowest pitch to highest on open vowels) designed to strengthen and balance airflow with muscular effort was prescribed. Blake also participated in daily homework practice focused on correct articulation, prosody, and resonance of target multisyllabic words. The S LP created videos on Blake‟s tablet of a close-up of her mouth producing each target word. Blake recorded at least one of his productions of each target word for playback during treatment sessions to ensure he was practicing correctly at home.

[Q3] Use Case Study: Blake (see page 323) to answer the following question: When Blake met with his SLP, what did treatment consist of?

[Q3 Model Response] Blake met with the SLP twice weekly for drill production practice of complex, multisyllabic words related to coursework vocabulary. Repeated practice following clinician models and feedback, with progression from single words to words in sentences, and finally paragraph reading resulted in significantly reduced hypernasality and nasal emission on high-pressure sounds. Overall articulation and prosody also improved for targeted words.

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(c) Chapter 9 Test Items 1.

is the quality of the voice that is produced from sound vibrations in the pharyngeal, oral, and nasal cavities. a. Prosody b. Resonance c. Frequency d. Pitch

2. Velopharyngeal dysfunction is failure of the velopharyngeal mechanism to separate the and cavities during speech and swallowing. a. oral, nasal b. oral, pharyngeal c. pharyngeal, laryngeal d. laryngeal, oral 3.

is the perceptual correlate of fundamental frequency associated with the rate of vocal fold vibration. a. Resonance b. Pitch c. Vocal loudness d. Decibels

4.

is the perceptual correlate of intensity. a. Resonance b. Pitch c. Vocal loudness d. Decibels

5.

is a result of not varying habitual speaking frequency. a. Strained vocal quality b. Harshness c. Monopitch voice d. Monotone voice

6. Modifications in the length and produce pitch change.

of the vocal folds are necessary to

a. tension b. width 13 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

c. height d. All of the above 7. The loudness of conversational speech is around

.

a. 30 dB b. 45 dB c. 60 dB d. 100 dB 8. In children 3–10 years of age, the prevalence of voice disorders is about . a. 1% b. 6% c. 10% d. 25% 9.

are reddened ulcerations on the posterior surface of the vocal folds in the region of the arytenoid cartilages. a. Vocal nodules b. Vocal polyps c. Contact ulcers d. Pedunculated polyps

10.

are fluid filled lesions that develop when blood vessels rupture and swell. a. Vocal polyps b. Vocal nodules c. Contact ulcers d. Granulomas

11. Unilateral or bilateral vocal fold paralysis is caused by damage to the recurrent branch of a. CN V . b. CN VII . c. CN VIII . d. CN X .

12.

is the preferred treatment for neurological or idiopathic spasmodic dysphonia. a. Surgery 14 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

b. Injection of Botox c. Vocal fold prosthesis d. Collagen injection 13.

are voice disorders are believed to result from emotional suppression. a. Spastic dysarthrias b. Chronic laryngitis c. Psychogenic voice disorders d. Spasmodic dysphonias

14. A is an abnormal opening in an anatomical structure caused by a failure of the structures to fuse or merge correctly early in embryonic development. a. cleft b. granuloma c. glottis d. nasal emission 15.

occurs when the velopharyngeal mechanism fails to decouple the oral and nasal cavities. a. Hyponasality b. Glottal stopping c. Hypernasality d. Monoloudness

16.

can occur when there is a partial blockage somewhere in the nasopharynx or nasal cavity, causing an insufficient amount of nasal resonance. a. Hypernasality b. Hyponasality c. Nasal emission d. Monoloudness

17. A(n) laryngeal structures.

is a lens and light source that can be used to view the

a. fluoroscope b. nasometer c. laryngometer d. endoscope

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18.

is a motion picture X-ray recorded on DVD, which permits the imaging of velopharyngeal function from three different perspectives. a. Multi-view videofluorsocopy b. Nasometer c. Endoscope d. VFSS

19.

is recommended for voice disorders associated with benign structural abnormalities that result from and are maintained by vocal misuse or abuse. a. Voice therapy b. Permanent vocal rest c. Collagen injections d. Surgical removal

20. In addition to raising vocal pitch in males transitioning to female or lowering pitch in females transitioning to males, which of the following is/are additional therapeutic technique(s) in the transgender population? a. Training males transitioning to female to slightly retract their lips to shorten the vocal tract b. Training females transitioning to male to use a more breathy voice quality c. Training males transitioning to female to increase vocal intensity d. Training males transitioning to female to restrict vocal range 21. Children born with cleft palate often undergo surgical closure of the cleft around what age? a. 3 months b. 6 months c. 12 months d. 18 months 22. Surgical repair of a cleft lip occurs a. before 3 months of age. b. around 6 months. c. around 9 months. d. after 12 months.

23.

is an 8-week muscle resistance home-training program designed to strengthen the muscles of the soft palate during speech production. a. Electropalatography (E PG) 16 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

b. Continuous positive airway pressure (C PAP) c. Lee Silverman Voice Treatment (L SVT) d. Palatal Strengthening Treatment (P ST) 24. For voice disorders associated with misuse/abuse, some neurological disorders, and psychological or stress conditions, voice treatment has been shown to be . a. ineffective b. mildly effective c. reasonably effective d. highly effective 25.

refers to age-related changes in the larynx that can lead to perceptual changes in pitch, pitch range, loudness, and voice quality in older adults. a. Puberphonia b. Mutational falsetto c. Spasmodic dysphonia d. Presbyphonia

26. During a resonance evaluation, a can be used to measure the relative amplitude of acoustic energy being emitted via the nose and mouth during phonation. a. nasography b. nasendoscopy procedure c. nasometer d. videofluoroscope 27. Vocal pitch is measured in .

, whereas vocal loudness is measured in

28. Fundamental frequency for men is around and children can be up to .

, women are around

29. For voice disorders, deviations may be in what three domains?

30. Describe vocal nodules, the affected population, the effects on the voice, and treatment.

31. Compare and contrast acute and chronic laryngitis.

32. Name four voice symptoms of Parkinson disease.

33. Name three vocal behaviors that may predispose some individuals to voice disorders.

34. What are the vocal characteristics of congenital laryngeal webbing?

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,

35. Discuss three alternative methods of producing voice after removal of the larynx due to laryngeal cancer.

36. What information does the SLP gather for the case history of a voice evaluation?

37. What three characteristics does the perceptual portion of the voice evaluation examine?

38. Describe LSVT as a behavioral treatment for voice and resonance.

39. Why is psychiatric referral often not needed for voice disorders associated with psychological or stress conditions?

40. Describe three types of prosthetics used in management of resonance disorders.

41. Describe the role of person-centered counseling in gender-affirming voice and communication intervention.

42. Name the structures of the velopharyngeal mechanism.

43. What are the effects of hormone medications on voice for transgender males and females?

44. At what point is a voice disorder said to exist?

45. Which professionals (at a minimum) are required to conduct a voice evaluation?

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(d) Chapter 9 Test Answer Key 1. B (see page 294, Introduction) 2. A (see page 294, Introduction) 3. B (see page 295, section titled “Vocal Pitch”) 4. C (see page 296, section titled “Vocal Loudness”) 5. D (see page 296, section titled “Vocal Pitch”) 6. A (see page 296, section titled “Vocal Pitch”) 7. C (see page 296, section titled “Vocal Loudness”) 8. B (see page 299, section titled “Disorders of Voice and Resonance”) 9. C (see page 302, section titled “Contact Ulcers and Granulomas”) 10. A (see page 301, section titled “Vocal Polyps”) 11. D (see page 306, table titled “Voice Characteristics Associated with Neurological Damage or Disease”) 12. B (see page 322, section titled “Medical/Surgical Management for Voice and Resonance”) 13. C (see page 307, table titled “Common Functional Voice Disorders”) 14. A (see page 308, section titled “Resonance Disorders”) 15. C (see page 308, section titled “Resonance Disorders”) 16. B (see page 309, section titled “Resonance Disorders”) 17. D (see page 309, section titled “The Voice Evaluation”) 18. A (see page 314, section titled “The Resonance Evaluation”) 19. A (see page 317, section titled “Behavioral Treatment for Voice and Resonance”) 20. A (see pages 325-326, section titled “Behavioral Treatment for Voice and Resonance”) 21. C (see page 320, section titled “Medical/Surgical Treatment for Voice and Resonance”) 22. A (see page 320, section titled “Medical/Surgical Treatment for Voice and Resonance”) 23. B (see page 318, section titled “Behavioral Treatment for Voice and Resonance”) 24. C (see page 327, section titled “Efficacy of Voice and Resonance Treatment”) 25. D (see page 297, section titled “Lifespan Issues”) 26. C (see page 313, section titled “The Resonance Evaluation”) 27. Answers should include the following (see pages 295–296, sections titled “Vocal Pitch” and “Vocal Loudness”): 19 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

hertz, decibels 28. Answers should include the following (see page 295, section titled “Vocal Pitch”): 125 Hz, 250 Hz, 500 Hz 29. Answers may vary, but should include the following points (see page 299, section titled “Disorders of Voice and Resonance”): Quality, pitch, and loudness 30. Answers may vary, but should include the following points (see pages 300–301, section titled “Vocal Nodules”): Localized growths resulting from frequent, hard vocal fold collisions. Generally bilateral, occurring at the juncture of the anterior one-third and posterior two-thirds of the vocal folds. Nodules are soft and pliable at first, and can become hard and fibrous. Most common in adult women between 20 and 50 years old. Can also occur in children (mostly boys) prone to excessive loud talking or screaming. The primary perceptual voice symptoms are hoarsness and breathiness. May complain of a sore throat and an inability to use the upper third of the pitch range. Newly formed nodules are often treated with vocal rest. Consulting an SLP for voice therapy and education is usually recommended. Longstanding nodules may require surgical removal followed by voice therapy.

31. Answers may vary, but should include the following points (see page 303, section titled “Laryngitis”): Acute laryngitis is a temporary swelling of the vocal folds that can result in hoarseness. Chronic laryngitis results from vocal abuse during acute laryngitis, and can lead to serious deterioration of vocal fold tissue.

32. Answers may vary, but should include the following points (see page 306, table titled “Voice Characteristics Associated with Neurological Damage or Disease”): Monopitch, monoloudness, breathiness, hoarseness, harshness, loudness 33. Answers may vary, but should include the following points (see page 299, section titled “Disorders of Voice and Resonance”): Loud talking, coughing, throat clearing 34. Answers may vary, but should include the following points (see page 304, section titled “Webs”): High pitch, hoarseness, and/or aphonia 35. Answers may vary, but should include the following points (see pages 318 and 320, sections titled “Behavioral Treatment for Voice and Resonance” and “Prosthetic Treatment for Voice and Resonance”): Esophageal speech: Uses the esophagus as a vibratory source. Electrolarynx: A prosthetic vibratory device. Tracheo-esophageal puncture or shunt: Directs air into the esophagus, allowing the speaker to use respiratory air and the cricopharyngeous muscle for voice production.

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36. Answers may vary, but should include the following points (see page 311, section titled “The Voice Evaluation”): Description of the voice problem, when it started, the duration, what the client believes might be causing it, how it affects daily life activities, the person‟s social and vocational use of the voice, and his or her overall physical and psychological condition.

37. Answers may vary, but should include the following points (see page 311, section titled “The Voice Evaluation”): Pitch, loudness, and voice characteristics 38. Answers may vary, but should include the following points (see pages 321–322, section titled “Behavioral Treatment for Voice and Resonance”): An evidence-based behavioral approach directly targeting the respiratory and laryngeal systems. It is an intensive treatment program originally designed for patients with Parkinson disease. Its focus is systematic increase of phonatory effort using intensive treatment and multiple repetitions of productions. LSVT has proven to be beneficial for improving voice function not only in patients with Parkinson disease but also in individuals with other progressive and nonprogressive neurological diseases across the lifespan.

39. Answers may vary, but should include the following points (see page 324, section titled “Behavioral Treatment for Voice”): Voice treatment can be effective if the individual is convinced there is nothing physically wrong via specific voicing techniques. The voice can return to normal in minutes or over several sessions.

40. Answers may vary, but should include the following points (see pages 321 and 323, sections titled “Prosthetic Treatment for Voice and Resonance” and “Prosthetic Management for Voice and Resonance”): A palatal obturator is similar to a retainer and can be used to cover a defect such as a fistula until further surgery is warranted. A speech bulb obturator can be used when the velum is too short to contact the posterior pharyngeal wall or when the velum is immobile. A palatal lift can be used to elevate the velum in cases where the velum is immobile.

41. Answers may vary, but should include the following points (see page 362, section titled “Behavioral Treatment for Voice and Resonance”): Involves connecting the client and guiding them to feel independent and selfconfident as their voice and communication characteristics are modified.

42. Answers may vary, but should include the following points (see page 298, section titled “Resonance”): The velum, the lateral pharyngeal walls, and the posterior pharyngeal wall.

43. Answers may vary, but should include the following points (see page 326, section titled “Medical/Surgical Treatment for Voice and Resonance”): 21 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

While testosterone therapy alone can lower voice in individuals assigned female at birth, most individuals benefit from behavioral interventions to optimize voice and resonance to best match their gender expression. Hormone replacement therapy for transgender females does not significantly alter pitch.

44. Answers may vary, but should include the following points (see page 299, section titled “Disorders of Voice and Resonance”): When one or more perceptual aspects of voice such as pitch, loudness, or voice quality are outside the range of normal for an individual‟s age, sex, cultural background, or geographic location.

45. Answers may vary, but should include the following points (see page 309, section titled “Evaluation of Voice and Resonance Disorders”): Otolaryngologist and an SLP

Article X. Chapter 10 Test Item File

Introduction to Communication Disorders A Lifespan Evidence-Based Perspective

Seventh Edition

Dr. Robert E. Owens, College of St. Rose Dr. Kimberly A. Farinella, Northern Arizona University 22 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Prepared by

Dr. Sarah A. Dachtyl

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Section 10.01

Table of Contents

Chapter 10: Motor Speech Disorders

1

Learning Objective Quizzes

1

Application Exercises

11

Test Items

14

Test Answer Key

18

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Section 10.02 Chapter 10: Motor Speech Disorders (a) Chapter 10 Learning Objective Quizzes Learning Objective 10.1: Describe the structures of the brain important for motor speech control.

[Q1] Lower motor neurons innervate structures on the

of the body.

1. quadrilateral portion 2. bilateral portions 3. ipsilateral side [correct] 4. contralateral side [Feedback for Answer Choice 1] Lower motor neurons are the paired cranial and spinal nerves that travel between the central nervous system (brain and spinal cord) and the sensory and motor structures that innervate on the ipsilateral side of the body.

[Feedback for Answer Choice 2] Lower motor neurons are the paired cranial and spinal nerves that travel between the central nervous system (brain and spinal cord) and the sensory and motor structures that innervate on the ipsilateral side of the body.

[Feedback for Correct Answer 3] Lower motor neurons are the paired cranial and spinal nerves that travel between the central nervous system (brain and spinal cord) and the sensory and motor structures that innervate on the ipsilateral side of the body.

[Feedback for Answer Choice 4] Lower motor neurons are the paired cranial and spinal nerves that travel between the central nervous system (brain and spinal cord) and the sensory and motor structures that innervate on the ipsilateral side of the body.

[Q2] Mr. Pendleton had a significant right hemisphere stroke. Because muscles on the left side of his body were deprived from all lower motor neuron input, he experienced: 1. paralysis. [correct] 2. incoordination.

3. paresis.

4. slowed movement.

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[Feedback for Correct Answer 1] Damage can result in paralysis (complete inability to move) if the muscle is deprived of all input from its lower motor neurons.

[Feedback for Answer Choice 2] Damage can result in paralysis (complete inability to move) if the muscle is deprived of all input from its lower motor neurons. This description is not consistent with incoordination.

[Feedback for Answer Choice 3] Damage can result in paralysis (complete inability to move) if the muscle is deprived of all input from its lower motor neurons. Damage to LMNs may result in weakness (paresis) if some of the LMNs supplying that muscle are still functioning.

[Feedback for Answer Choice 4] Damage can result in paralysis (complete inability to move) if the muscle is deprived of all input from its lower motor neurons. Complete loss of LMN input would be more substantial than slowed movement.

[Q3] The coordinates the control of fine, complex motor activities, maintains muscle tone, and participates in motor planning and motor learning.

1. cerebellar control circuit [correct] 2. primary motor cortex 3. peripheral nervous system 4. final common pathway [Feedback for Correct Answer 1] The cerebellum and cerebellar control circuitry coordinates the control of fine, complex motor activities like speech production, maintains muscle tone, and participates in the planning of movements and motor learning of new physical skills.

[Feedback for Answer Choice 2] The cerebellum and cerebellar control circuitry coordinates the control of fine, complex motor activities like speech production, maintains muscle tone, and participates in the planning of movements and motor learning of new physical skills. These are not functions specific to the primary motor cortex.

[Feedback for Answer Choice 3] The cerebellum and cerebellar control circuitry coordinates the control of fine, complex motor activities like speech production, maintains muscle tone, and participates in the planning of movements and motor learning of new physical skills. These are not functions of the peripheral nervous system.

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The cerebellum and cerebellar control circuitry coordinates the control of fine, complex motor activities like speech production, maintains muscle tone, and participates in the planning of movements and motor learning of new physical skills. These are not functions of the final common pathway.

Learning Objective 10.2: Define dysarthria and briefly describe each type and common etiologies.

[Q1] Muscles that exhibit fatigue quickly.

are weak and soft, exhibit low tone, and

1. ataxia 2. flaccid paralysis [correct] 3. spasticity 4. hypokinesia [Feedback for Answer Choice 1] Muscles that exhibit flaccid paralysis are weak and soft, exhibit low tone, and fatigue quickly. Ataxia results in incoordination.

[Feedback for Correct Answer 2] Muscles that exhibit flaccid paralysis are weak and soft, exhibit low tone, and fatigue quickly.

[Feedback for Answer Choice 3] Muscles that exhibit flaccid paralysis are weak and soft, exhibit low tone, and fatigue quickly. In spasticity, reflexes become hyperactive, muscle tone is increased at rest, and individuals exhibit increased resistance to passive stretch.

[Feedback for Answer Choice 4] Muscles that exhibit flaccid paralysis are weak and soft, exhibit low tone, and fatigue quickly. Individuals with hypokinesia (reduced movement) feel stiff and find it difficult to get movements started.

[Q2] Often in individuals with , the articulators appear to be barely moving during speech production; the result is a fast rate of speech and diminishing loudness.

1. spastic dysarthria 2. flaccid dysarthria 3. ataxic dysarthria 4. hypokinetic dysarthria [correct]

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[Feedback for Answer Choice 1] In hypokinetic dysarthria, the articulators appear to be barely moving during speech production. As a result, speech rate becomes very fast, and loudness levels gradually diminish. The description is not consistent with spastic dysarthria.

[Feedback for Answer Choice 2] In hypokinetic dysarthria, the articulators appear to be barely moving during speech production. As a result, speech rate becomes very fast, and loudness levels gradually diminish. The description is not consistent with flaccid dysarthria.

[Feedback for Answer Choice 3] In hypokinetic dysarthria, the articulators appear to be barely moving during speech production. As a result, speech rate becomes very fast, and loudness levels gradually diminish. The description is not consistent with ataxic dysarthria.

[Feedback for Correct Answer 4] In hypokinetic dysarthria, the articulators appear to be barely moving during speech production. As a result, speech rate becomes very fast, and loudness levels gradually diminish.

[Q3] SLPs can work to improve the quality of life for individuals with profound dysarthria with the use of 1. voice amplifiers.

2. abdominal binders.

3. AAC devices. [correct] 4. palatal lifts.

[Feedback for Answer Choice 1] The individual may be unable to speak at all, and the SLP can work to improve the quality of life for individuals with profound dysarthria with the help of A AC devices.

Voice amplifiers would not be effective for most individuals with profound dysarthria.

[Feedback for Answer Choice 2] The individual may be unable to speak at all, and the SLP can work to improve the quality of life for individuals with profound dysarthria with the help of AAC devices.

Abdominal binders would not be effective for most individuals with profound dysarthria.

[Feedback for Correct Answer 3] The individual may be unable to speak at all, and the SLP can work to improve the quality of life for individuals with profound dysarthria with the help of AAC devices.

[Feedback for Answer Choice 4]

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The individual may be unable to speak at all, and the SLP can work to improve the quality of life for individuals with profound dysarthria with the help of AAC devices.

Palatal lifts would not be effective for individuals with profound dysarthria.

Learning Objective 10.3: Define apraxia of speech (A OS) and describe speech characteristics associated with AOS and common etiologies.

[Q1] results in an inability to adequately retrieve speech motor programs, which causes disordered articulation of vowels and consonants, slowed rate, and prosodic disturbances.

1. Hyperkinetic dysarthria 2. Ataxic dysarthria 3. Flaccid dysarthria 4. Apraxia of speech [correct] [Feedback for Answer Choice 1] Apraxia of speech results in an inability to adequately retrieve speech motor programs, which causes disordered articulation of vowels and consonants, slowed rate, and prosodic disturbances. This description is not consistent with hyperkinetic dysarthria.

[Feedback for Answer Choice 2] Apraxia of speech results in an inability to adequately retrieve speech motor programs, which causes disordered articulation of vowels and consonants, slowed rate, and prosodic disturbances. This description is not consistent with ataxic dysarthria.

[Feedback for Answer Choice 3] Apraxia of speech results in an inability to adequately retrieve speech motor programs, which causes disordered articulation of vowels and consonants, slowed rate, and prosodic disturbances. This description is not consistent with flaccid dysarthria.

[Feedback for Correct Answer 4] Apraxia of speech results in an inability to adequately retrieve speech motor programs, which causes disordered articulation of vowels and consonants, slowed rate, and prosodic disturbances.

[Q2] Mrs. del Campo has acquired apraxia of speech. Because she monitors her speech in anticipation of errors, her speech tends to be slowed, with 1. variable stress patterns.

2. equal stress and spacing. [correct] 3. occasional rapid repetitions.

4. errors in monosyllabic words.

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[Feedback for Answer Choice 1] Monitoring of speech in anticipation of errors tends to be slowed, with equal stress and spacing. Variable stress patterns would not likely be present.

[Feedback for Correct Answer 2] Monitoring of speech in anticipation of errors tends to be slowed, with equal stress and spacing.

[Feedback for Answer Choice 3] Monitoring of speech in anticipation of errors tends to be slowed, with equal stress and spacing. Rapid repetitions would not likely be present.

[Feedback for Answer Choice 4] Monitoring of speech in anticipation of errors tends to be slowed, with equal stress and spacing. Errors in monosyllabic words are not related to slowed speech rate.

[Q3] In most individuals, apraxia of speech results following 1. a right hemisphere stroke.

2. a cerebellar stroke.

3. a left hemisphere stroke. [correct] 4. a brainstem stroke.

[Feedback for Answer Choice 1] Most individuals who acquire apraxia of speech do so following a stroke in the left hemisphere, specifically Broca‟s area in the left frontal lobe. Apraxia of speech is not likely to occur after a right hemisphere stroke.

[Feedback for Answer Choice 2] Most individuals who acquire apraxia of speech do so following a stroke in the left hemisphere, specifically Broca‟s area in the left frontal lobe. Apraxia of speech would not occur after a cerebellar stroke.

[Feedback for Correct Answer 3] Most individuals who acquire apraxia of speech do so following a stroke in the left hemisphere, specifically Broca‟s area in the left frontal lobe.

[Feedback for Answer Choice 4] Most individuals who acquire apraxia of speech do so following a stroke in the left hemisphere, specifically Broca‟s area in the left frontal lobe. Apraxia of speech would not occur after a brainstem stroke.

Learning Objective 10.4: Describe assessment techniques for motor speech disorders.

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In the evaluation of motor speech disorders, the SLP evaluates the structure and function of , connected speech, and speech in special tasks.

1. the oral mechanism [correct] 2. upper motor neurons 3. lower motor neurons 4. the brain [Feedback for Correct Answer 1] The SLP will evaluate the structure and function of the oral mechanism, connected speech, and speech in special tasks.

[Feedback for Answer Choice 2] The SLP will evaluate the structure and function of the oral mechanism, connected speech, and speech in special tasks. The SLP does not evaluate the structure of upper motor neurons.

[Feedback for Answer Choice 3] The SLP will evaluate the structure and function of the oral mechanism, connected speech, and speech in special tasks. The SLP does not evaluate the structure of lower motor neurons.

[Feedback for Answer Choice 4] The SLP will evaluate the structure and function of the oral mechanism, connected speech, and speech in special tasks. The SLP does not evaluate the structure of the brain.

[Q2] Which of the following tasks can specifically help in the differential diagnosis for apraxia of speech?

1. Collection of a thorough case history 2. Rapid repetition of “puh,” “tuh,” “kuh,” and “puh-tuh-kuh” [correct] 3. An oral peripheral examination 4. An evaluation of velopharyngeal function [Feedback for Answer Choice 1] The following speech production tasks can help in differential diagnosis for apraxia of speech: imitation of single words of varying lengths, sentence imitation, reading aloud, spontaneous speech, and rapid repetition of “puh,” “tuh,” “kuh” and “puh-tuh-kuh.”

Collection of a thorough case history is not specific to apraxia of speech.

[Feedback for Correct Answer 2]

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The following speech production tasks can help in differential diagnosis for apraxia of speech: imitation of single words of varying lengths, sentence imitation, reading aloud, spontaneous speech, and rapid repetition of “puh,” “tuh,” “kuh” and “puh-tuh-kuh.”

[Feedback for Answer Choice 3] The following speech production tasks can help in differential diagnosis for apraxia of speech: imitation of single words of varying lengths, sentence imitation, reading aloud, spontaneous speech, and rapid repetition of “puh,” “tuh,” “kuh” and “puh-tuh-kuh.”

Conducting an oral peripheral examination is not specific to apraxia of speech.

[Feedback for Answer Choice 4] The following speech production tasks can help in differential diagnosis for apraxia of speech: imitation of single words of varying lengths, sentence imitation, reading aloud, spontaneous speech, and rapid repetition of “puh,” “tuh,” “kuh,” and “puh-tuh-kuh.” An evaluation of velopharyngeal function is not specific to apraxia of speech.

[Q3] Errors may be

in apraxia of speech.

1. phonological in nature 2. due to weakness 3. inconsistent [correct] 4. due to increased muscle tone [Feedback for Answer Choice 1] Performance in apraxia of speech will likely vary with repeated performance, and errors may be inconsistent. Errors are not phonological.

[Feedback for Answer Choice 2] Performance in apraxia of speech will likely vary with repeated performance, and errors may be inconsistent. Errors are not due to weakness.

[Feedback for Correct Answer 3] Performance in apraxia of speech will likely vary with repeated performance, and errors may be inconsistent.

[Feedback for Answer Choice 4] Performance in apraxia of speech will likely vary with repeated performance, and errors may be inconsistent. Errors are not due to increased muscle tone.

Learning Objective 10.5: Briefly explain evidence-based treatments for dysarthria and apraxia.

[Q1] Mrs. Glidden participated in , an evidence-based behavioral treatment that increases phonatory competence in adults with Parkinson disease.

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1. voice amplification 2. medialization laryngoplasty 3. Lee Silverman Voice Treatment [correct] 4. EPG [Feedback for Answer Choice 1] Lee Silverman Voice Treatment (L SVT) is an evidence-based behavioral approach to increasing phonatory competence in adults with Parkinson disease and for treating respiratory and phonatory deficits in children with spastic cerebral palsy. Voice amplification is a prosthetic intervention.

[Feedback for Answer Choice 2] Lee Silverman Voice Treatment (LSVT) is an evidence-based behavioral approach to increasing phonatory competence in adults with Parkinson disease and for treating respiratory and phonatory deficits in children with spastic cerebral palsy. Medialization laryngoplasty is a surgical intervention.

[Feedback for Correct Answer 3] Lee Silverman Voice Treatment (LSVT) is an evidence-based behavioral approach to increasing phonatory competence in adults with Parkinson disease and for treating respiratory and phonatory deficits in children with spastic cerebral palsy.

[Feedback for Answer Choice 4] Lee Silverman Voice Treatment (LSVT) is an evidence-based behavioral approach to increasing phonatory competence in adults with Parkinson disease and for treating respiratory and phonatory deficits in children with spastic cerebral palsy. EPG is used for articulatory precision.

[Q2] and a palatal lift can be used to improve velopharyngeal function.

1. Continuous positive airway pressure [correct] 2. Intensive, repetitive speech drills 3. EPG 4. Speech supplementation [Feedback for Correct Answer 1] Continuous positive airway pressure (C PAP) and a palatal lift can be used to improve velopharyngeal function.

[Feedback for Answer Choice 2]

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Continuous positive airway pressure (CPAP) and a palatal lift can be used to improve velopharyngeal function. Intensive, repetitive speech drills is an effective way to increase articulatory accuracy.

[Feedback for Answer Choice 3] Continuous positive airway pressure (CPAP) and a palatal lift can be used to improve velopharyngeal function. EPG is used for articulatory precision.

[Feedback for Answer Choice 4] Continuous positive airway pressure (CPAP) and a palatal lift can be used to improve velopharyngeal function. Speech supplementation strategies, such as alphabet cues, do not improve velopharyngeal function.

[Q3] Mr. Llewelyn participated in one of the most effective treatments for apraxia of speech, which involves using a “watch me, listen to me, and do what I do” paradigm. Which of the following treatments is this?

1. Melodic intonation therapy 2. Contrastive stress treatment 3. Nonspeech oral motor treatment 4. Integral stimulation [correct] [Feedback for Answer Choice 1] Integral stimulation is one of the most effective treatments and involves using a “watch me, listen to me, and do what I do” paradigm. Melodic intonation therapy is a treatment that focuses on prosody, emphasizing the melody, rhythm, and stress patterns of spoken utterances.

[Feedback for Answer Choice 2] Integral stimulation is one of the most effective treatments and involves using a “watch me, listen to me, and do what I do” paradigm. In contrastive stress, the client produces sentences by emphasizing stress on particular words, changing the meaning of the sentence.

[Feedback for Answer Choice 3] Integral stimulation is one of the most effective treatments and involves using a “watch me, listen to me, and do what I do” paradigm. Despite the popularity of nonspeech oral motor treatments, evidence-based practice suggests that there is insufficient evidence to support their use and are not recommended to improve articulation in adults and children with dysarthria.

[Feedback for Correct Answer 4] Integral stimulation is one of the most effective treatments and involves using a “watch me, listen to me, and do what I do” paradigm.

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(b) Chapter 10 Application Exercises Application Exercise 10.1: Describe dysarthria related to etiology.

Learning Objective 10.2: Define dysarthria and briefly describe each type and common etiologies.

Reference: Case Study: Genevieve (see page 342), Table 10.1 (see page 341), and Table 10.2 (see page 344) [Q1] Use Case Study: Genevieve (see page 342), Table 10.1 (see page 341), and Table 10.2 (see page 344) to answer the following question: In the case study of Genevieve, discuss her diagnosis and physical effects.

[Q1 Model Response] Genevieve was diagnosed with Parkinson disease, which is associated with a progressive loss of dopaminergic neurons. The patient experiences slowed, rigid movements, reduced range of motion, and hypokinetic dysarthria.

[Q2] Use Case Study: Genevieve (see page 342), Table 10.1 (see page 341), and Table 10.2 (see page 344) to answer the following question: Given the information in Table 10.2, describe the details related to Parkinson disease.

[Q2 Model Response] Parkinson disease is the most common neurological movement disorder. It is associated with degeneration of neurons that produce dopamine, the neurotransmitter important in regulating the direct and indirect control loops of the basal ganglia.

[Q3] Use Case Study: Genevieve (see page 342), Table 10.1 (see page 341), and Table 10.2 (see page 344) to answer the following question: Given the information in Table 10.1, describe the speech characteristics of hypokinetic dysarthria.

[Q3 Model Response] The speech characteristics of hypokinetic dysarthria are accelerated speech rate, imprecise articulation due to reduced range of motion of the articulators, breathy/harsh/hoarse voice quality, reduced loudness, and disfluencies.

Application Exercise 10.2: Describe unique features of apraxia of speech.

Learning Objective 10.3: Define apraxia of speech (AOS) and describe speech characteristics associated with AOS and common etiologies.

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Reference: Table 10.3 (see page 347) [Q1] Use Table 10.3 (see page 347) to answer the following question: Given the information in Table 10.3 describing the differences between dysarthria and apraxia of speech, outline the sound errors that can be exhibited in AOS. [Q1 Model Response] In AOS, a patient may experience speech-sound substitutions, which may be unrelated to the target phoneme; inconsistent speech-sound substitutions; and schwa often inserted between consonants in a cluster.

[Q2] Use Table 10.3 (see page 347) to answer the following question: Given the information in Table 10.3 describing the differences between dysarthria and apraxia of speech, outline the speech rate feature in AOS. [Q2 Model Response] Slow rate is often experienced in AOS, due to repetitions, prolongations, and additions.

[Q3] Use Table 10.3 (see page 347) to answer the following question: Given the information in Table 10.3 describing the difference between dysarthria and apraxia of speech, outline the fluency characteristics of AOS. [Q3 Model Response] There are islands of fluency in AOS, and often very fluent reactive or automatic speech but nonfluent volitional speech.

Application Exercise 10.3: Describe treatment for an individual with a motor speech disorder.

Learning Objective 10.4: Briefly explain evidence-based treatments for dysarthria and apraxia.

Reference: Case Study: Genevieve (see page 352) [Q1] Use Case Study: Genevieve (see page 352) to answer the following question: In this case study, describe Genevieve‟s LSV T LOUD treatment.

[Q1 Model Response] Genevieve participated in 16 sessions of LSVT LOUD over four weeks. Functional phrases were practiced.

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[Q2] Use Case Study: Genevieve (see page 352) to answer the following question: After completing LSVT LOUD treatment, what treatment did Genevieve participate in next?

[Q2 Model Response] Genevieve participated in LSVT BIG next. She also then participated in a combined speech therapy and physical therapy program.

[Q3] Use Case Study: Genevieve (see page 352) to answer the following question: What are examples of dual task activities that Genevieve participated in?

[Q3 Model Response] Dual task activities included practice using her LSVT LOUD voice in functional phrases while simulating household chores, like picking up clothes from the ground and placing them into a laundry basket or putting away dishes from the dishwasher into upper cabinets.

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(c) Chapter 10 Test Items 1.

are responsible for muscle activation and represent the final common pathway. a. Upper motor neurons b. Reflexes c. Control circuits d. Lower motor neurons

2. The originate(s) in the primary motor cortex and is/are responsible for rapid, discrete, volitional movement of the limbs and articulators for speech. a. pyramidal tract or direct activation pathway b. extrapyramidal tract or indirect activation pathway c. basal ganglia control circuit d. cerebellar control circuit 3. The is/are important for regulating reflexes and maintaining posture and muscle tone, providing the necessary framework to facilitate movement. a. pyramidal tract or direct activation pathway b. cerebellum c. extrapyramidal tract or indirect activation pathway d. frontal lobes 4. The spinal nerves.

consists of 12 pairs of cranial nerves and 31 pairs of

a. central nervous system b. peripheral nervous system c. vertebral column d. brainstem 5.

is a category of dysarthria that usually results from lesions in the cranial and spinal nerves or in the muscle unit itself. May result in reduced respiratory drive for speech breathing, continuously breathy voice quality, reduced pitch and loudness levels, hypernasality, and imprecise articulation. a. spastic dysarthria b. flaccid dysarthria c. hyperkinetic dysarthria d. hypokinetic dysarthria

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6.

has utility in increasing articulatory precision in children with dysarthria due to CP and in adults with acquired dysarthria. a. Palatal lift b. VFSS c. CPAP d. EPG

7. In , reflexes become hyperactive, muscle tone is increased at rest, and individuals exhibit increased resistance to passive stretch. a. spastic dysarthria b. flaccid dysarthria c. hyperkinetic dysarthria d. ataxic dysarthria 8.

is a category of dysarthria that is due to damage in the cerebellum or cerebellar control circuitry. It results in incoordination and the improper timing of movements. a. Spastic dysarthria b. Hyperkinetic dysarthria c. Ataxic dysarthria d. Hypokinetic dysarthria

9.

results in slow movements with reduced range of motion due to the effects of rigidity. a. Flaccid dysarthria b. Hyperkinetic dysarthria c. Ataxic dysarthria d. Hypokinetic dysarthria

10. In , the client produces sentences by emphasizing particular words, changing the meaning of the sentence. a. contrastive stress b. dynamic stress c. melodic stress d. facilitative stress 11.

is a category of dysarthria that is due to damage of the basal ganglia circuitry; the indirect pathway and/or structures of the basal ganglia that help to inhibit unwanted movements are damaged. a. Hyperkinetic dysarthria 15 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

b. Hypokinetic dysarthria c. Ataxic dysarthria d. Flaccid dysarthria 12. In , both upper and lower motor neurons degenerate, causing mixed flaccid and spastic dysarthria. a. traumatic brain injury b. primary progressive aphasia c. Alzheimer‟s disease d. amyotrophic lateral sclerosis 13.

is a neurological speech disorder that impairs the ability to plan or program the sensory and motor commands needed for speech production. a. Dysarthria b. Apraxia of speech c. Aphasia d. Dementia

14. For individuals who recover after acquiring apraxia of speech, which is the most common residual deficit? a. Articulation of nasal consonants b. Prosodic abnormalities c. Difficulty socializing d. Cognitive impairment 15.

is a congenital disorder that causes dysarthria in children. a. Childhood apraxia of speech b. Cerebral palsy c. Down syndrome d. Fragile X syndrome

16.

is an effective treatment for acquired apraxia of speech. It involves a hierarchy of cueing to help a client retrain his or her motor planning/programming abilities. a. Integral stimulation b. Melodic intonation therapy c. Contrastive stress therapy d. Lee Silverman Voice Treatment

17. In

, there is a focus on prosody, emphasizing the melody, 16 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

rhythm, and stress patterns of spoken utterances. This treatment technique for acquired apraxia of speech is thought to access functions of the right hemisphere. a. integral stimulation b. melodic intonation therapy c. contrastive stress therapy d. Lee Silverman Voice Treatment 18. The direct and indirect activation pathways form the

.

19. How do the basal ganglia modulate motor activity?

20. Damage to lower motor neurons may result in which two possibilities?

21. The whereas the majority of purposes.

nerves are especially important for speech production, nerves are important for breathing

22. Special control systems in the

govern breathing for life.

23. Dysarthria can affect what aspects of movement?

24. What speech domains may be affected in dysarthria?

25. What two etiologies most frequently result in apraxia of speech?

26. Name five speech characteristics of apraxia of speech.

27. Describe the use of alphabet cues as a speech supplementation strategy.

28. What are the movement and speech characteristics associated with spastic dysarthria?

29. What are the speech and motor characteristics of ataxic dysarthria?

30. What are the speech and movement characteristics of hypokinetic dysarthria?

31. Name abnormal involuntary movements that may be seen in hyperkinetic dysarthria.

32. What are the speech characteristics of hyperkinetic dysarthria?

33. How might acquiring dysarthria change an adult‟s life?

34. What are the purposes of the motor speech evaluation?

35. What speech tasks might be used for differential diagnosis of apraxia of speech?

36. Name techniques that can be used to improve respiratory drive.

37.

are NOT recommended as a treatment technique for motor speech disorders.

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(d) Chapter 10 Test Answer Key 1. D (see page 333, section titled “Structures of the Brain Important for Motor Speech Control”) 2. A (see pages 334–335, section titled “Structures of the Brain Important for Motor Speech Control”) 3. C (see page 335, section titled “Structures of the Brain Important for Motor Speech Control”) 4. B (see page 338, section titled “Cranial Nerves Important for Speech Production”) 5. B (see page 340, section titled “Flaccid Dysarthrias”) 6. D (see page 351, section titled “Management of Dysarthria”) 7. A (see page 341, section titled “Spastic Dysarthria”) 8. C (see page 341, section titled “Ataxic Dysarthria”) 9. D (see page 342, section titled “Hypokinetic Dysarthria”) 10. A (see page 353, section titled “Management of Apraxia of Speech”) 11. A (see pages 342–343, section titled “Hyperkinetic Dysarthria”) 12. D (see page 343, section titled “Mixed Dysarthria”) 13. B (see page 345, section titled “Motor Speech Disorders: Apraxia of Speech”) 14. B (see page 347, section titled “Lifespan Issues”) 15. B (see page 343, section titled “Lifespan Issues”) 16. A (see page 352, section titled “Management of Apraxia of Speech”) 17. B (see page 353, section titled “Management of Apraxia of Speech”) 18. Answers should include the following (see page 336, section titled “Structures of the Brain Important for Motor Speech Control”): upper motor neuron system 19. Answers will vary, but should include some of the following points (see page 337, section titled “Structures of the Brain Important for Motor Speech Control”): The basal ganglia modulate the activity of the primary motor cortex and indirectly influence movement. Depending on which pathway is involved, damage to the basal ganglia will either result in reduced and/or slowed movement (Parkinson disease) or in abnormal, involuntary movements (Huntington‟s chorea).

20. Answers should include the following (see page 333, section titled “Structures of the Brain Important for Motor Speech Control”): Paresis or paralysis 21. Answers should include the following (see page 338, section titled “Cranial Nerves Important for Speech Production”): 18 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

cranial; spinal 22. Answers should include the following (see page 338, section titled “Cranial Nerves Important for Speech Production”): brainstem 23. Answers should include the following (see page 340, section titled “Motor Speech Disorders: Dysarthria”): Speed, range, and timing of movement 24. Answers should include the following (see page 340, section titled “Motor Speech Disorders: Dysarthria”): Respiration, phonation, resonance, and/or articulation 25. Answers should include the following (see pages 346–347, section titled “Lifespan Issues”): Stroke or degenerative disease 26. Answers will vary, but should include some of the following points (see page 345, section titled “Motor Speech Disorders: Apraxia of Speech”): Groping attempts to find the correct articulatory position; great variability over repeated attempts, sound substitutions, omissions, additions, and difficulty sequencing sounds in multisyllabic words.

27. Answers will vary, but should include some of the following points (see page 351, section titled “Management of Dysarthria”): The speaker points to the first letter of each word on an alphabet board as they say the word, combined with topic cues, to help slow speech rate as well as allow listeners to better predict the speaker‟s intended message.

28. Answers will vary, but should include some of the following points (see page 341, section titled “Spastic Dysarthria”): Movements of the articulators become slowed and reduced in force and range of motion. Spasticity at the level of the larynx results in a strain-strangled voice quality.

29. Answers will vary, but should include some of the following points (see pages 341– 342, section titled “Ataxic Dysarthria”): Ataxic dysarthria reflects the effects of incoordination and the improper timing of movements, causing irregular breakdowns in articulation and abnormalities of prosody. Movements are inaccurate, jerky, and lacking smoothness.

30. Answers will vary, but should include some of the following points (see page 342, section titled “Hypokinetic Dysarthria”): Individuals with hypokinesia feel stiff and find it difficult to get movements started.

Once started, they struggle to stop. Reduced range of motion is the hallmark feature.

Speech rate becomes very fast and disfluencies are common. Loudness levels gradually diminish.

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31. Answers will vary, but should include some of the following points (see page 343, section titled “Hyperkinetic Dysarthria”): Tics, dystonia, chorea, tremor 32. Answers will vary, but should include some of the following points (see page 343, section titled “Hyperkinetic Dysarthria”): Hyperkinetic dysarthria is essentially the production of motorically normal speech that is interrupted in some fashion by abnormal involuntary movements. Speech is characterized by variable speech rate, irregular articulatory breakdowns, and significant prosodic abnormalities.

33. Answers will vary, but should include some of the following points (see pages 343– 344, section titled “Lifespan Issues”): For some, even a slight speech abnormality can be cause for embarrassment and depression. In more severe cases, individuals may be frustrated as loved ones and acquaintances attempt to communicate for them by finishing their sentences or ordering for them in restaurants. This may cause them to socialize less. In the later stages of progressive degenerative diseases, and individual with dysarthria may be unable to live independently and may need daily living assistance or institutional care.

34. Answers will vary, but should include some of the following points (see page 348, section titled “Evaluation of Motor Speech Disorders”): To determine whether a significant and long-term problem exists. To describe the nature of impaired functions, specifically the types of problems, the extent/severity, and the effects of these impairments on everyday functioning. To identify functions that are not impaired. To establish appropriate goals and decide where to begin intervention. To form a well-reasoned prognosis, based on the nature of the disorder, the client‟s age, the age or stage of injury or disease, the presence of other conditions, client motivation, and family support.

35. Answers will vary, but should include some of the following points (see page 348, section titled “Evaluation of Motor Speech Disorders”): Imitation of single words of varying length. Sentence imitation. Reading aloud.

Spontaneous speech. Rapid repetition of “puh,” “tuh,” “kuh,” and “puh-tuh-kuh” or “buttercup.”

36. Answers will vary, but should include some of the following points (see page 350, section titled “Management of Dysarthria”): Helping speakers with dysarthria learn to increase pauses and breaths during speech helps improve respiratory drive and coordination, thereby increasing speech intelligibility. If respiratory muscle weakness impedes the use of that strategy, an abdominal binder is an effective prosthetic for increasing respiratory drive, improving loudness and voice quality. Patients with severe respiratory weakness and significantly reduced loudness can use voice amplifiers.

37. Answers should include the following (see page 352, section titled “Management of 20 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Dysarthria”): Nonspeech oral motor treatments

Article XI. Chapter 11 Test Item File

Introduction to Communication Disorders A Lifespan Evidence-Based Perspective

Seventh Edition

Dr. Robert E. Owens, College of St. Rose Dr. Kimberly A. Farinella, Northern Arizona University

Prepared by

Dr. Sarah A. Dachtyl

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Section 11.01

Table of Contents

Chapter 11: Disorders of Swallowing

1

Learning Objective Quizzes

1

Application Exercises

9

Test Items

12

Test Answer Key

18

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Section 11.02 Chapter 11: Disorders of Swallowing (a) Chapter 11 Learning Objective Quizzes Learning Objective 11.1: Describe the normal and disordered processes of swallowing.

[Q1] Once the bolus is formed, the

phase of the swallow begins.

1. oral transport [correct] 2. oral preparation 3. pharyngeal 4. oesophageal [Feedback for Correct Answer 1] Once the bolus is formed, the oral transport (or transit) stage begins.

[Feedback for Answer Choice 2] Once the bolus is formed, the oral transport (or transit) stage begins. The oral preparation phase is first.

[Feedback for Answer Choice 3] Once the bolus is formed, the oral transport (or transit) stage begins. The pharyngeal phase follows.

[Feedback for Answer Choice 4] Once the bolus is formed, the oral transport (or transit) stage begins. The oesophageal phase is two steps removed.

[Q2] During the pharyngeal phase of the swallow, why does the velum move up to meet the rear wall of the pharynx?

1. To prevent the prepared bolus from spilling into the pulmonary airways 2. To move the bolus from the front to the back of the mouth 3. To squeeze the bolus down 4. To prevent the bolus from going into the nasal cavity [correct] [Feedback for Answer Choice 1] During the pharyngeal phase of the swallow, the velum moves up to meet the rear wall of the pharynx to prevent the bolus from going into the nasal cavity. Movement of the velum does not prevent the bolus from spilling into the pulmonary airways.

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[Feedback for Answer Choice 2] During the pharyngeal phase of the swallow, the velum moves up to meet the rear wall of the pharynx to prevent the bolus from going into the nasal cavity. Movement of the velum does not move the bolus from the front to the back of the mouth.

[Feedback for Answer Choice 3] During the pharyngeal phase of the swallow, the velum moves up to meet the rear wall of the pharynx to prevent the bolus from going into the nasal cavity. Movement of the velum does not squeeze the bolus down.

[Feedback for Correct Answer 4] During the pharyngeal phase of the swallow, the velum moves up to meet the rear wall of the pharynx to prevent the bolus from going into the nasal cavity.

[Q3] What could happen if peristalsis is slow or absent during the oesophageal phase?

1. Material can remain in the pharynx after the swallow.

2. The complete bolus might not be transported to the stomach. [correct] 3. Pocketing can occur.

4. The risk of reflux increases.

[Feedback for Answer Choice 1] If peristalsis is slow or absent, the complete bolus might not be transported to the stomach. Material remaining in the pharynx is unrelated to the oesophageal phase.

[Feedback for Correct Answer 2] If peristalsis is slow or absent, the complete bolus might not be transported to the stomach.

[Feedback for Answer Choice 3] If peristalsis is slow or absent, the complete bolus might not be transported to the stomach. Pocketing is unrelated to the oesophageal phase.

[Feedback for Answer Choice 4] If peristalsis is slow or absent, the complete bolus might not be transported to the stomach. Reflux is unrelated to oesophageal peristalsis.

Learning Objective 11.2: List and describe common etiologies of pediatric and adult dysphagia.

[Q1] Which of the following is a common etiology of feeding and swallowing disorders?

1. Depression

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2. Head and neck cancer [correct] 3. Diabetes 4. ADHD [Feedback for Answer Choice 1] Common etiologies of feeding and swallowing disorders in children and adults include: prematurity, cerebral palsy, intellectual and developmental disability, autism spectrum disorder, craniofacial anomalies, stroke, head and neck cancer, Parkinson disease, traumatic brain injury, and dementia. Depression is not a common etiology of feeding and swallowing disorders.

[Feedback for Correct Answer 2] Common etiologies of feeding and swallowing disorders in children and adults include: prematurity, cerebral palsy, intellectual and developmental disability, autism spectrum disorder, craniofacial anomalies, stroke, head and neck cancer, Parkinson disease, traumatic brain injury, and dementia.

[Feedback for Answer Choice 3] Common etiologies of feeding and swallowing disorders in children and adults include: prematurity, cerebral palsy, intellectual and developmental disability, autism spectrum disorder, craniofacial anomalies, stroke, head and neck cancer, Parkinson disease, traumatic brain injury, and dementia. Diabetes is not a common etiology of feeding and swallowing disorders.

[Feedback for Answer Choice 4] Common etiologies of feeding and swallowing disorders in children and adults include: prematurity, cerebral palsy, intellectual and developmental disability, autism spectrum disorder, craniofacial anomalies, stroke, head and neck cancer, Parkinson disease, traumatic brain injury, and dementia. ADHD is not a common etiology of feeding and swallowing disorders.

[Q2] As they age, infants may refuse food and develop 1. difficulty nursing.

2. impairments in the pharyngeal phase of the swallow.

3. unhealthy food preferences. [correct] 4. impairments in the oral preparation phase of the swallow.

[Feedback for Answer Choice 1] As they age, infants may refuse food and develop unhealthy food preferences. Food refusal does not directly lead to a development of difficulty nursing.

[Feedback for Answer Choice 2]

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As they age, infants may refuse food and develop unhealthy food preferences. Food refusal is not related to development of pharyngeal phase impairments.

[Feedback for Correct Answer 3] As they age, infants may refuse food and develop unhealthy food preferences.

[Feedback for Answer Choice 4] As they age, infants may refuse food and develop unhealthy food preferences. Food refusal is not related to development of oral preparation phase difficulties.

[Q3] The lifetime prevalence rate of dysphagia has been found to be study of adults aged 65–94 years old and living independently.

in a

1. 16% 2. 27% 3. 38% [correct] 4. 59% [Feedback for Answer Choice 1] One study indicated a lifetime dysphagia prevalence rate of 38% in 117 adults between ages 65 and 94 years of age who were living independently.

[Feedback for Answer Choice 2] One study indicated a lifetime dysphagia prevalence rate of 38% in 117 adults between ages 65 and 94 years of age who were living independently.

[Feedback for Correct Answer 3] One study indicated a lifetime dysphagia prevalence rate of 38% in 117 adults between ages 65 and 94 years of age who were living independently.

[Feedback for Answer Choice 4] One study indicated a lifetime dysphagia prevalence rate of 38% in 117 adults between ages 65 and 94 years of age who were living independently.

Learning Objective 11.3: List and describe the important components of the swallowing evaluation.

[Q1] Brooklyn failed a swallow screening. Which of the following should happen next given the information in this chapter?

1. Intervention should occur immediately.

2. Brooklyn should not be allowed to eat or drink until she can undergo a V FSS. 3. Additional clinical assessment. [correct] 4 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

4. A referral for placement of a feeding tube.

[Feedback for Answer Choice 1] When feeding or swallowing difficulties are suspected based on the screening, or the patient is at risk for feeding and/or swallowing difficulties, additional clinical assessment is needed to determine whether and what type of intervention should occur.

[Feedback for Answer Choice 2] When feeding or swallowing difficulties are suspected based on the screening, or the patient is at risk for feeding and/or swallowing difficulties, additional clinical assessment is needed before determining whether Brooklyn can safely eat or drink.

[Feedback for Correct Answer 3] When feeding or swallowing difficulties are suspected based on the screening, or the patient is at risk for feeding and/or swallowing difficulties, additional clinical assessment is needed.

[Feedback for Answer Choice 4] When feeding or swallowing difficulties are suspected based on the screening, or the patient is at risk for feeding and/or swallowing difficulties, additional clinical assessment is needed before determining whether Brooklyn can safely eat or drink.

[Q2] During swallow trials, the S LP will determine if the patient has food or liquid from entering the airway.

to keep

1. sufficient oral reflexes 2. sufficient facial symmetry 3. multiple swallows 4. a protective cough [correct] [Feedback for Answer Choice 1] During swallow trials, the SLP will determine if the patient has a protective cough to keep food or liquid from entering the airway. Oral reflexes do not protect the airway.

[Feedback for Answer Choice 2] During swallow trials, the SLP will determine if the patient has a protective cough to keep food or liquid from entering the airway. Facial symmetry does not protect the airway.

[Feedback for Answer Choice 3] During swallow trials, the SLP will determine if the patient has a protective cough to keep food or liquid from entering the airway. Multiple swallows is a strategy that may be taught during therapeutic intervention.

[Feedback for Correct Answer 4] 5 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

During swallow trials, the SLP will determine if the patient has a protective cough to keep food or liquid from entering the airway.

[Q3] cannot be viewed with F EES due to a “white-out” period.

1. The actual swallow [correct] 2. Pharyngeal residue 3. The epiglottis 4. Bolus spillage into the pharynx before the swallow [Feedback for Correct Answer 1] The actual swallow cannot be viewed with FEES due to a “white-out” period when the epiglottis obscures the view.

[Feedback for Answer Choice 2] The actual swallow cannot be viewed with FEES due to a “white-out” period when the epiglottis obscures the view. When the scope is in place, the inside of the pharynx is clearly visible.

[Feedback for Answer Choice 3] The actual swallow cannot be viewed with FEES due to a “white-out” period when the epiglottis obscures the view.

[Feedback for Answer Choice 4] The actual swallow cannot be viewed with FEES due to a “white-out” period when the epiglottis obscures the view. FEES may reveal bolus spilling into the pharynx before swallowing, and residue may be seen after the swallow.

Learning Objective 11.4: Describe evidence-based swallowing treatments for children and adults.

[Q1] is a nonoral feeding method that bypasses the gastrointestinal tract and administers nutrition through a vein.

1. A jejunostomy tube 2. Total parenteral nutrition [correct] 3. A percutaneous endoscopic gastrostomy tube 4. A nasogastric tube [Feedback for Answer Choice 1]

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Total parenteral nutrition (T PN) is a nonoral feeding method that bypasses the gastrointestinal tract and administers a specialized solution of nutrition through a vein. A jejunostomy tube (J-tube) is inserted into the middle part of the small intestine.

[Feedback for Correct Answer 2] Total parenteral nutrition (TPN) is a nonoral feeding method that bypasses the gastrointestinal tract and administers a specialized solution of nutrition through a vein.

[Feedback for Answer Choice 3] Total parenteral nutrition (TPN) is a nonoral feeding method that bypasses the gastrointestinal tract and administers a specialized solution of nutrition through a vein. A percutaneous endoscopic gastrostomy tube (P EG or G-tube) is inserted through the abdomen into the stomach.

[Feedback for Answer Choice 4] Total parenteral nutrition (TPN) is a nonoral feeding method that bypasses the gastrointestinal tract and administers a specialized solution of nutrition through a vein. A nasogastric tube is placed through the nose, pharynx, esophagus, and into the stomach.

[Q2] Compensatory positioning strategies require patient compliance, , and the physical capability to complete such maneuvers and manage swallowing disorders effectively.

1. adequate expressive language 2. a strong cough 3. a regular/unmodified diet 4. adequate intellectual abilities [correct] [Feedback for Answer Choice 1] Compensatory positioning strategies require patient compliance, adequate intellectual abilities, and the physical capability to complete such maneuvers and manage swallowing disorders effectively in the short term. Adequate expressive language is not necessary.

[Feedback for Answer Choice 2] Compensatory positioning strategies require patient compliance, adequate intellectual abilities, and the physical capability to complete such maneuvers and manage swallowing disorders effectively in the short term. A strong cough is not listed as being necessary.

[Feedback for Answer Choice 3] Compensatory positioning strategies require patient compliance, adequate intellectual abilities, and the physical capability to complete such maneuvers and manage

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swallowing disorders effectively in the short term. A regular/unmodified diet is not necessary.

[Feedback for Correct Answer 4] Compensatory positioning strategies require patient compliance, adequate intellectual abilities, and the physical capability to complete such maneuvers and manage swallowing disorders effectively in the short term.

[Q3] has/have demonstrated improvement in physiological impairments of swallowing.

1. Neuromuscular electrical stimulation (NMES) alone 2. Surface electromyography 3. Exercises that involve a swallow [correct] 4. The Mendelsohn maneuver [Feedback for Answer Choice 1] Exercises that involve a swallow have demonstrated improvement in physiological impairments of swallowing. Research has shown that NMES combined with swallowingspecific exercises results in better outcomes for post-stroke patients.

[Feedback for Answer Choice 2] Exercises that involve a swallow have demonstrated improvement in physiological impairments of swallowing. Surface electromyography can provide real-time information about muscles activation during swallowing.

[Feedback for Correct Answer 3] Exercises that involve a swallow have demonstrated improvement in physiological impairments of swallowing.

[Feedback for Answer Choice 4] Exercises that involve a swallow have demonstrated improvement in physiological impairments of swallowing. In the Mendelsohn maneuver, the patient is taught to hold the larynx manually at its highest point during the swallow. It does not result in physiological improvements.

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(b) Chapter 11 Application Exercises Application Exercise 11.1: Describe personal experience with disordered swallowing.

Learning Objective 11.1: Describe the normal and disordered processes of swallowing.

Reference: Case Study: Steve (see page 358) [Q1] Use Case Study: Steve (see page 358) to answer the following question: In this case study, Steve experienced dysphagia. What are the dangers of dysphagia as stated in the case study?

[Q1 Model Response] Any difficulty swallowing foods or liquids can result in choking, aspiration, or aspiration pneumonia.

[Q2] Use Case Study: Steve (see page 358) to answer the following question: In this case study, what specific difficulties did Steve experience?

[Q2 Model Response] Steve had difficulty swallowing his favorite drink, Diet Coke. He was not able to eat his favorite foods, such as nuts or toast. If he ate toast, it would take him two hours to finish. He expressed that it felt like food was getting stuck at the level of his voice box, and he had to cough after eating.

Application Exercise 11.2: Describe the effects of common etiologies on swallowing function.

Learning Objective 11.2: List and describe common etiologies of pediatric and adult dysphagia.

Reference: Table 11.1 (see pages 363 and 364) [Q1] Use Table 11.1 (see pages 363 and 364) to answer the following question: Given the information in Table 11.1, describe feeding and swallowing disorders related to autism spectrum disorders (A SD).

[Q1 Model Response] Feeding problems in children with ASD may result from repetitive patterns of behavior or sensory issues that restrict the types of food consumed, possibly leading to poor nutrition. Children with ASD with sensory processing deficits may be hypersensitive to sound, light, pain, smell, and touch. Avoidance is common when children with sensory 9 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

disorders are introduced to new foods, with negative responses like spitting, gagging, or vomiting occurring.

[Q2] Use Table 11.1 (see pages 363 and 364) to answer the following question: Given the information in Table 11.1, describe feeding and swallowing disorders related to cerebral palsy (CP).

[Q2 Model Response] Gastroesophageal reflux is common in infants and children with C P and ingestion of food may be painful. Reduced lip closure, drooling, poor tongue function, exaggerated bite reflex, delayed swallow initiation, and reduced pharyngeal motility are types of oral and pharyngeal problems exhibited by children with C P. In severe cases, children with CP require gastrostomy tube feedings.

[Q3] Use Table 11.1 (see pages 363 and 364) to answer the following question: Given the information in Table 11.1, describe feeding and swallowing disorders related to stroke.

[Q3 Model Response] Oral-motor and sensory deficits are common after stroke. Tongue weakness may interfere with the ability to control the bolus or propel it posteriorly into the oropharynx.

Poor awareness of food or liquid in the mouth may result in holding the bolus in the mouth for long periods. Facial weakness can lead to pocketing of food inside the cheek.

Sensory deficits in the larynx and pharynx and a decreased cough reflex can cause silent aspiration, or aspiration with no apparent sign or response.

Application Exercise 11.3: Describe a personal experience with swallowing treatment.

Learning Objective 11.4: Describe evidence-based swallowing treatments for children and adults.

Reference: Case Study: Steve (see pages 376 and 381) [Q1] Use Case Study: Steve (see pages 376 and 381) to answer the following question: What were the recommendations for Steve within the case study given the results of the MBSS, and what was his response?

[Q1 Model Response] Based on the MBSS, it was recommended that Steve eat soft foods and continue with mildly thick liquids. He was not pleased about thickening his Diet Coke.

[Q2] 10 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Use Case Study: Steve (see pages 376 and 381) to answer the following question: What swallowing exercises were recommended to Steve?

[Q2 Model Response] The effortful swallow and Mendelsohn maneuver were recommended for Steve. NMES of neck muscles was combined with the swallow exercises. Surface electromyography was used for biofeedback.

[Q3] Use Case Study: Steve (see pages 376 and 381) to answer the following question: What was the goal of Steve‟s home program?

[Q3 Model Response] Steve‟s goal was to complete approximately 100 therapeutic swallows daily, which was approximately 20 effortful swallows and 10 Mendelsohn maneuvers three times per day.

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(c) Chapter 11 Test Items 1. Swallowing disorders increase the risk of choking and may lead to . a. obesity b. aspiration c. intubation d. improved nutrition 2. In the phase of swallowing, the tongue and cheeks move food to the teeth to form a solid bolus. a. oral preparation b. oral transport c. pharyngeal d. oesophageal 3. In the phase of swallowing, the base of the tongue and the pharyngeal wall move toward one another to create pressure needed to project the bolus into the pharynx. a. oral preparation b. oral transport c. pharyngeal d. oesophageal 4. In the phase of swallowing, the bolus is moved from the front to the back of the mouth. a. oral preparation b. oral transport c. pharyngeal d. oesophageal 5. In the phase of swallowing, muscles move the bolus in peristaltic contractions into the stomach. a. oral preparation b. oral transport c. pharyngeal d. oesophageal 6. Which of the following can occur in disorders of the oral preparation/oral phase of swallowing?

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a. Insufficient saliva impedes adequate bolus formation b. Poor tongue mobility may result in insufficient pressure in the pharynx c. If the swallow is not triggered or is delayed, material may be aspirated d. Residue on the oesophageal walls can result in infection and nutritional problems 7. Which of the following can occur in disorders of the pharyngeal phase of swallowing? a. If the lips do not seal properly, drooling can occur. b. The muscles of the tongue might not function purposefully or efficiently enough to move food to the teeth. c. An open velopharyngeal port can lead to substances going into and out of the nose. d. If peristalsis is slow or absent, the complete bolus might not be transported to the stomach.

8. What percentage of SLPs who work in adult settings report that swallowing disorders were among the top five areas they treat? a. 25% b. 39% c. 59% d. 86% 9. For adults 50 years of age and over living in skilled nursing facilities, prevalence rates of dysphagia are over . a. 60% b. 70% c. 85% d. 85% 10. The is a screener that consists of a brief cognitive screening, an oral mechanism examination, and a 3 ounce water challenge. a. Frazier water protocol b. FEES c. Yale swallow protocol d. X-ray swallow study 11. If a patient fails the 3 ounce water challenge, the next step is to . a. perform an instrumental swallow exam b. place an NG tube 13 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

c. place a PEG tube d. order a diet modification 12.

is/are a risk factor for aspiration pneumonia. a. History of smoking b. Reduced muscle tone c. Reduced oral reflexes d. Poor oral hygiene

13. Multiple swallows may suggest

.

a. poor oral transport b. inadequate pharyngeal swallow reflex c. inadequate pharyngeal contraction d. impaired oesophageal peristalsis 14. A primary indication of dysphagia in infants is a. failure to thrive. b. irritability. c. cognitive impairment. d. lack of attachment.

15. Which of the following is likely the most effective instrumental technique for patients with head and neck cancer and those with anatomical changes post-surgery or trauma? a. FEES b. VFSS c. MBSS d. Ultrasonography 16.

are temporary measures to maintain client safety with oral intake of food or liquids until recovery or improvement of swallowing function occurs. a. Direct rehabilitation strategies b. Indirect rehabilitation strategies c. Compensatory techniques d. Nonoral feedings

17. During swallow trials, an inability to cough may indicate a. difficulty closing the larynx to protect the airway. b. inadequate velopharyngeal closure.

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c. oesophageal residue. d. aspiration pneumonia.

18. In , a flexible laryngoscope is placed through the nose and into the pharynx so that the swallow can be examined. a. videofluoroscopy b. scintigraphy c. fiberoptic endoscopic evaluation of swallowing d. ultrasound 19. In , barium is coated onto or mixed into the food or beverage so that the movement of the bolus can be examined via X-ray. a. videofluoroscopy b. ccintigraphy c. fiberoptic endoscopic evaluation of swallowing d. ultrasonography 20.

may improve chewing, thereby increasing efficiency and safety during meals. a. The Mendelsohn maneuver b. Oral motor exercises c. Elimination of straw use d. Modifications to food consistency

21. The is an international, standardized, culturally sensitive system used to describe modifications to foods and liquids that improve the safety and efficiency of swallowing. a. International Dysphagia Diet Standardization Initiative b. International Swallowing and Feeding Initiative c. International Diet Modification Initiative d. International Feeding Safety Initiative 22. Muscle strength and coordination to improve swallowing function can be improved through . a. exercise b. electrical stimulation c. surgery d. diet modifications 23.

is used as a biofeedback tool for the patient as they can watch muscle movement on the monitor and adjust as needed.

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a. VFSS b. sEMG c. MBSS d. X-ray biofeedback 24. Clients who require more than seconds to swallow a bolus or who aspirate more than will likely require at least some nonoral feeding. a. 5, 5% b. 10, 10% c. 20, 20% d. 40, 40% 25.

works by applying electrical stimulation to the neck area via surface electrodes and eliciting contractions of the targeted muscles for swallowing. a. sEMG b. MBSS c. VFSS d. NMES

26.

is a feeding tube placed in the stomach through a hole in the abdomen. a. Nasogastric tube b. Pharyngostomy c. Esophagostomy d. Percutaneous endoscopic gastrostomy tube

27. Name two overt symptoms of aspiration.

28.

is the movement of food or acid from the stomach back into the esophagus.

29. Name four outcomes of a swallowing disorder at any age.

30. How can an inefficient swallow be problematic at the pharyngeal phase?

31. How can residue on the oesophageal walls be problematic?

32. Name five common etiologies of feeding and swallowing disorders in children and adults.

33. Under what conditions can swallow trials be conducted?

34. When placing a finger gently on the neck, what structures should move upward during the swallow?

35. FEES can provide information about what three factors important to the swallow?

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36. What are the three areas of concern that might result in a dysphagia referral?

37. What does the SLP pay attention to when observing feeding as it occurs normally in terms of caregiver and environmental factors?

38. What are the aims of direct and indirect rehabilitation treatments for swallowing?

39. After physician approval is granted, describe the process involved in conducting a swallowing evaluation with an individual who has a tracheostomy tube.

40. What is the optimal body and head positioning for feeding and swallowing?

41. Name three examples of postures used as compensatory techniques for dysphagia.

42. Describe the four principles of exercise science that guide improvement in swallowing physiology.

43. What is the procedure for the supraglottic and super-supraglottic swallow?

44. When is the Mendelsohn maneuver used and what is the procedure?

45. Name two surgical procedures that may help with dysphagia.

46. What are the benefits of early identification and successful intervention for dysphagia?

47. The feeding environment can be modified in a number of ways to ensure it is conducive to success during meals. Name six possibilities.

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(d) Chapter 11 Test Answer Key 1. B (see page 358, Introduction) 2. A (see page 359, section titled “Oral Preparation Phase”) 3. C (see page 359, section titled “Pharyngeal Phase”) 4. B (see page 359, section titled “Oral Transport Phase”) 5. D (see page 360, section titled “Esophageal Phase”) 6. A (see page 361, section titled “Oral Preparation/Oral Transport Phase”) 7. C (see page 361, section titled “Pharyngeal Phase”) 8. C (see page 357, Introduction) 9. A (see page 362, section titled “Etiologies of Pediatric and Adult Dysphagia”) 10. C (see page 365, section titled “Screening for Dysphagia”) 11. A (see page 365, section titled “Screening for Dysphagia”) 12. D (see page 368, section titled “Oral Mechanism”) 13. C (see page 369, section titled “Swallow Trials”) 14. A (see page 365, section titled “Screening for Dysphagia”) 15. A (see page 374, section titled “Fiberoptic Endoscopic Evaluation of Swallowing”) 16. C (see page 374, section titled “Treatment of Swallowing Disorders”) 17. A (see page 368, section titled “Swallow Trials”) 18. C (see page 371, section titled “Fiberoptic Endoscopic Evaluation of Swallowing”) 19. A (see page 371, section titled “Videofluoroscopic Swallowing Study”) 20. D (see page 376, section titled “Modification of Foods and Liquids”) 21. A (see page 376, section titled “Modification of Foods and Liquids”) 22. A (see page 378, section titled “Exercise-Based Therapy”) 23. B (see page 380, section titled “Surface Electromyography”) 24. B (see page 376, section titled “Nonoral Feeding”) 25. D (see page 380, section titled “Neuromuscular Electrical Stimulation”) 26. D (see page 376, section titled “Nonoral Feeding”) 27. Answers will vary, but should include the following (see page 368, section titled “Swallow Trials”): Coughing, throat clearing 28. Answers will vary, but should include the following (see page 358, “Introduction”): Gastroesophageal reflux (G ER)

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29. Answers will vary, but should include the following (see page 364, section titled “Lifespan Issues”): Malnutrition, poor health, fatigue, dehydration, prolonged feeding times, weight loss, frustration, aspiration, death 30. Answers will vary, but should include the following (see page 361, section titled “Pharyngeal Phase”): If the swallow is inefficient, material can remain in the pharynx after the swallow, increasing risk for aspiration of the retained material after the swallow or during a subsequent swallow.

31. Answers will vary, but should include the following (see page 361, section titled “Esophageal Phase”): Residue on the esophageal walls can result in infection and nutritional problems.

Reflux from retained material in the esophagus may reach the level of the pharynx, increasing risk of aspiration after the swallow.

32. Answers will vary, but should include the following (see pages 363–364, table titled “Common Etiologies of Feeding and Swallowing Disorders in Children and Adults”): Prematurity, cerebral palsy, intellectual and developmental disability, autism spectrum disorder, craniofacial anomalies, stroke, head and neck cancer, Parkinson disease, traumatic brain injury, dementia 33. Answers will vary, but should include the following (see page 368, section titled “Swallow Trials”): If the client is alert and manages his/her saliva without any signs of aspiration or respiratory compromise.

34. Answers will vary, but should include the following (see page 369, section titled “Swallow Trials”): Hyoid bone and thyroid cartilage 35. Answers will vary, but should include the following (see page 373, section titled “Fiberoptic Endoscopic Evaluation of Swallowing”): Body and head posture, preferred food types, and aspiration 36. Answers will vary, but should include the following (see page 367, section titled “Case History and Background Information”): Difficulties have been observed related to feeding and ingestion of food or liquid.

The client appears to be at risk for aspirating food or liquid into the lungs. The client appears not to be receiving adequate nourishment.

37. Answers will vary, but should include the following (see page 368, section titled “Caregiver and Environmental Factors”): Is the caregiver patient and attentive? Does feeding take place in a reasonably quiet environment free from distractions? What position is the individual in when eating or drinking? How does the client express feeding preferences?

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38. Answers will vary, but should include the following (see page 374, section titled “Treatment of Swallowing Disorders”): Direct and indirect rehabilitation treatments are aimed at changing swallowing physiology by accelerating recovery of swallowing function after a stroke or other acquired, nonprogressive disorder. Direct and indirect treatments also help maintain swallowing function in progressive diseases for as long as possible or, in the case of pediatric disorders like prematurity, help develop the skills needed for feeding and swallowing effectiveness and efficiency.

39. Answers will vary, but should include the following (see page 369, section titled “Managing a Tracheostomy Tube”): The cuff is deflated and a speaking valve is placed, if possible. Speaking valves can increase swallowing efficiency and decrease aspiration risk by facilitating expiration through the upper airway after swallowing. The patient covers the tube before each swallow to normalize tracheal pressure.

40. Answers will vary, but should include the following (see page 377, section titled “Body and Head Positioning”): An upright, symmetrical position with a 90 degree hip angle and sufficient postural support to provide stability is optimal. The individual‟s head and neck must be positioned and prevented from making extraneous movement, as able.

41. Answers will vary, but should include the following (see page 377, section titled “Body and Head Positioning”): Chin tuck, head-back, head tilt, head rotation, lay on the side of the stronger pharyngeal side down.

42. Answers will vary, but should include the following (see page 379, section titled “Exercise-Based Therapy”): Task specificity, or ensuring the movements involved in the treatment match the motor movements to be improved with respect to speed and force; muscle load, or the generation of muscle force during contraction; resistance, or the ability of muscles to resist external pressures; intensity, or the strength and amount of practice of specific exercises to achieve the desired outcomes.

43. Answers will vary, but should include the following (see page 379, section titled “Swallowing-Specific Exercises”): Teach voluntary closure of the glottal area through effortful breath holding, with the additional instruction to bear down for the super-supraglottic swallow.

44. Answers will vary, but should include the following (see page 380, section titled “Swallowing-Specific Exercises”): The Mendelsohn maneuver is useful for clients who do not have adequate laryngeal elevation. The patient is taught to hold the larynx manually at its highest point during the swallow.

45. Answers will vary, but should include the following (see page 382, section titled 20 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

“Prostheses and Surgical Procedures”): Removing growths on the cervical spine, elevating the larynx, surgical procedures to increase the dimensions of the vocal folds.

46. Answers will vary, but should include the following (see page 382, section titled “Treatment Effectiveness and Outcomes for Swallowing Disorders”): Reduces the risk of aspiration and death, shortens the length of time patients need to stay in the hospital, and improves quality of life.

47. Answers will vary, but should include the following (see page 375, section titled “Feeding Environment”): Visual and auditory distractions should be minimized. The eating area should not contain irrelevant items. Lighting should be comfortable and noise reduced. The caregiver should be relaxed and tuned in to the client regarding feeding speed, food preferences, and quantity. Attention and focus to the person being fed and reinforcement of healthy, effective eating behaviors are important. Utensils for feeding need to be appropriate to the age and functioning of the client. For infants, a slow-flow nipple may be helpful in controlling the amount of liquid taken at a time. A Teflon or latex-covered spoon may be used for children with immature oral reflexes who may bite hard on any object placed in the mouth. Children and adults with motor coordination difficulties may benefit from using a shallow-bowled spoon. Special cutout cups may help to improve tongue positioning when drinking. Eliminating the use of a straw may be helpful in managing the amount of liquid ingested.

Article XII. Chapter 12 Test Item File

Introduction to Communication Disorders A Lifespan Evidence-Based Perspective

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Seventh Edition

Dr. Robert E. Owens, College of St. Rose Dr. Kimberly A. Farinella, Northern Arizona University

Prepared by

Dr. Sarah A. Dachtyl

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Section 12.01

Table of Contents

Chapter 12: Audiology and Hearing Loss

1

Learning Objective Quizzes

1

Application Exercises

16

Test Items

19

Test Answer Key

28

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Section 12.02 Chapter 12: Audiology and Hearing Loss (a) Chapter 12 Learning Objective Quizzes Learning Objective 12.1: Describe the effects of hearing loss on children and adults.

[Q1] Which of the following does the W HO recommend to prevent hearing loss? (a) Immunizing children to prevent disease (b) Improved prenatal care (c) Improve hygiene practices (d) Greater access to medications to treat infections 1. Answer (a) only 2. Answers (b) and (c) only 3. Answers (c) and (d) only 4. Answers (a), (c), and (d) only [correct] [Feedback for Answer Choice 1] The W HO recommends the following to prevent hearing loss: Immunizing children to prevent disease and screening to identify disease early, greater access to medications to treat infections, improved hygiene practices, avoidance of medications that damage the inner ear structures, early hearing testing, and better information for young people regarding noise-induced hearing loss.

[Feedback for Answer Choice 2] The W HO recommends the following to prevent hearing loss: Immunizing children to prevent disease and screening to identify disease early, greater access to medications to treat infections, improved hygiene practices, avoidance of medications that damage the inner ear structures, early hearing testing, and better information for young people regarding noise-induced hearing loss.

[Feedback for Answer Choice 3] The W HO recommends the following to prevent hearing loss: Immunizing children to prevent disease and screening to identify disease early, greater access to medications to treat infections, improved hygiene practices, avoidance of medications that damage the inner ear structures, early hearing testing, and better information for young people regarding noise-induced hearing loss.

[Feedback for Correct Answer 4] The W HO recommends the following to prevent hearing loss: Immunizing children to prevent disease and screening to identify disease early, greater access to medications to treat infections, improved hygiene practices, avoidance of medications that damage 1 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

the inner ear structures, early hearing testing, and better information for young people regarding noise-induced hearing loss.

[Q2] Lisa has a hearing loss but does not have does not interfere with her ability to participate in life situations.

because her loss

1. a hearing handicap [correct] 2. a hearing impairment 3. residual hearing 4. a threshold shift [Feedback for Correct Answer 1] Many individuals who have hearing loss do not have a hearing handicap because their loss does not interfere with their ability to participate in life situations.

[Feedback for Answer Choice 2] Many individuals who have hearing loss do not have a hearing handicap because their loss does not interfere with their ability to participate in life situations. She does demonstrate an impairment, which is defined as “a loss of structure or function.”

[Feedback for Answer Choice 3] Many individuals who have hearing loss do not have a hearing handicap because their loss does not interfere with their ability to participate in life situations. Residual hearing refers to use of the hearing that remains after a hearing loss.

[Feedback for Answer Choice 4] Many individuals who have hearing loss do not have a hearing handicap because their loss does not interfere with their ability to participate in life situations. Lisa has a permanent threshold shift.

[Q3] Unlike ASL, forms of were developed for use in educational settings with children who are diagnosed with deafness to expose them to grammatical markers.

1. Pidgin Signed English (P SE) 2. Manually Coded English (MCE) [correct] 3. fingerspelling 4. Signed English [Feedback for Answer Choice 1] ASL is a language unto itself, with its own unique set of grammatical rules. Unlike ASL, forms of manually Coded English (MCE) were developed for use in educational settings 2 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

with children who are diagnosed with deafness to expose them to grammatical markers.

Some believe that this supports the development of English literacy skills and overall academic achievement. Pidgin Signed English (PSE uses a structure that is more English-like for new users, and more experienced users tend to incorporate more features of ASL. [Feedback for Correct Answer 2] ASL is a language unto itself, with its own unique set of grammatical rules. Unlike ASL, forms of manually Coded English (MCE) were developed for use in educational settings with children who are diagnosed with deafness to expose them to grammatical markers.

Some believe that this supports the development of English literacy skills and overall academic achievement.

[Feedback for Answer Choice 3] ASL is a language unto itself, with its own unique set of grammatical rules. Unlike ASL, forms of manually Coded English (MCE) were developed for use in educational settings with children who are diagnosed with deafness to expose them to grammatical markers.

Some believe that this supports the development of English literacy skills and overall academic achievement. In fingerspelling, hand shapes are used to visually represent each of the 26 letters of the English alphabet.

[Feedback for Answer Choice 4] ASL is a language unto itself, with its own unique set of grammatical rules. Unlike ASL, forms of manually Coded English (MCE) were developed for use in educational settings with children who are diagnosed with deafness to expose them to grammatical markers.

Some believe that this supports the development of English literacy skills and overall academic achievement. Signed English is a dialect of sign language that is designed to promote language development by providing equivalent signs for spoken words.

Learning Objective 12.2: Describe the role of the audiologist.

[Q1] Since 2007, the audiologists to practice.

has been the entry-level degree for

1. MA 2. MD 3. AuD [correct] 4. PhD [Feedback for Answer Choice 1] Since 2007, the AuD has been the entry-level degree for audiologists to practice.

[Feedback for Answer Choice 2] Since 2007, the AuD has been the entry-level degree for audiologists to practice.

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[Feedback for Correct Answer 3] Since 2007, the AuD has been the entry-level degree for audiologists to practice.

[Feedback for Answer Choice 4] Since 2007, the AuD has been the entry-level degree for audiologists to practice.

[Q2] are professionals who study techniques designed to promote the development of spoken language in individuals with significant hearing loss.

1. Hearing scientists 2. Audiologists 3. Listening and spoken language specialists [correct] 4. Otolaryngologists [Feedback for Answer Choice 1] Listening and spoken language (L SL) specialists, also sometimes referred to as auditory-verbal therapists (AVT) are professionals who study techniques designed to promote the development of spoken language in individuals with significant hearing loss. Hearing scientists study the biological, physical, and psychological processes of communication and use research to develop better ways to diagnose and treat individuals with hearing problems.

[Feedback for Answer Choice 2] Listening and spoken language (LSL) specialists, also sometimes referred to as auditory-verbal therapists (AVT) are professionals who study techniques designed to promote the development of spoken language in individuals with significant hearing loss. Audiologists are involved in the prevention of and assessment of auditory, vestibular, and related impairments as well as the habilitation/rehabilitation and maintenance of persons with these impairments.

[Feedback for Correct Answer 3] Listening and spoken language (LSL) specialists, also sometimes referred to as auditory-verbal therapists (AVT) are professionals who study techniques designed to promote the development of spoken language in individuals with significant hearing loss.

[Feedback for Answer Choice 4] Listening and spoken language (LSL) specialists, also sometimes referred to as auditory-verbal therapists (AVT) are professionals who study techniques designed to promote the development of spoken language in individuals with significant hearing loss. Otolaryngologists are ear, nose, and throat physicians.

[Q3]

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Audiologists are involved in the prevention and assessment of auditory, , and related impairments as well as the habilitation/rehabilitation and maintenance of persons with these impairments.

1. hearing 2. vestibular [correct] 3. speech 4. language [Feedback for Answer Choice 1] Audiologists are involved in the prevention of and assessment of auditory, vestibular, and related impairments as well as the habilitation/rehabilitation and maintenance of persons with these impairments.

[Feedback for Correct Answer 2] Audiologists are involved in the prevention of and assessment of auditory, vestibular, and related impairments as well as the habilitation/rehabilitation and maintenance of persons with these impairments.

[Feedback for Answer Choice 3] Audiologists are involved in the prevention of and assessment of auditory, vestibular, and related impairments as well as the habilitation/rehabilitation and maintenance of persons with these impairments.

[Feedback for Answer Choice 4] Audiologists are involved in the prevention of and assessment of auditory, vestibular, and related impairments as well as the habilitation/rehabilitation and maintenance of persons with these impairments.

Learning Objective 12.3: Describe the required elements for sound to be produced and perceived.

[Q1] For sound to occur and be perceived, there must be an energy source, an object capable of vibrating, , and a receptor.

1. compressions 2. a medium [correct] 3. rarefactions 4. amplitude [Feedback for Answer Choice 1] For sound to occur and be perceived there must be an energy source, an object capable of vibrating, a medium, and a receptor. Compressions are a part of the sound wave.

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[Feedback for Correct Answer 2] For sound to occur and be perceived there must be an energy source, an object capable of vibrating, a medium, and a receptor.

[Feedback for Answer Choice 3] For sound to occur and be perceived there must be an energy source, an object capable of vibrating, a medium, and a receptor. Rarefactions are a part of the sound wave.

[Feedback for Answer Choice 4] For sound to occur and be perceived there must be an energy source, an object capable of vibrating, a medium, and a receptor. Amplitude is the distance the vibrating object travels in either direction.

[Q2] Sound is a series of a vibrating source.

and rarefactions that move outward from

1. compressions [correct] 2. frequencies 3. amplitudes 4. vibrations [Feedback for Correct Answer 1] Sound is a series of compressions and rarefactions that move outward from a vibrating source.

[Feedback for Answer Choice 2] Sound is a series of compressions and rarefactions that move outward from a vibrating source. Frequency refers to the number of cycles of vibration per second.

[Feedback for Answer Choice 3] Sound is a series of compressions and rarefactions that move outward from a vibrating source. Amplitude is the distance the vibrating object travels in either direction.

[Feedback for Answer Choice 4] Sound is a series of compressions and rarefactions that move outward from a vibrating source. An object capable of vibrating produces sound and is not a component of it.

[Q3] Amplitude determines a sound‟s 1. frequency.

2. duration.

3. pitch.

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4. intensity. [correct] [Feedback for Answer Choice 1] Amplitude determines a sound‟s intensity. Frequency determines a sound‟s pitch.

[Feedback for Answer Choice 2] Amplitude determines a sound‟s intensity, rather than duration.

[Feedback for Answer Choice 3] Amplitude determines a sound‟s intensity. Frequency determines a sound‟s pitch.

[Feedback for Correct Answer 4] Amplitude determines a sound‟s intensity.

Learning Objective 12.4: Summarize the transmission of sound through the three main sections of the ear.

[Q1] The pinna collects and funnels sound into the ear canal and helps the listener identify where sound originates in space, called 1. spatial awareness.

2. sound detection.

3. localization. [correct] 4. central auditory processing.

[Feedback for Answer Choice 1] The pinna collects and funnels sound into the ear canal and helps the listener identify where sound originates in space, called localization.

[Feedback for Answer Choice 2] The pinna collects and funnels sound into the ear canal and helps the listener identify where sound originates in space, called localization.

[Feedback for Correct Answer 3] The pinna collects and funnels sound into the ear canal and helps the listener identify where sound originates in space, called localization.

[Feedback for Answer Choice 4] The pinna collects and funnels sound into the ear canal and helps the listener identify where sound originates in space, called localization.

[Q2] The Eustachian tube connects the middle ear with the 1. nasopharynx. [correct] 7 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

2. outer ear.

3. inner ear.

4. oval window.

[Feedback for Correct Answer 1] The Eustachian tube connects the middle ear with the nasopharynx.

[Feedback for Answer Choice 2] The Eustachian tube connects the middle ear with the nasopharynx, rather than the outer ear.

[Feedback for Answer Choice 3] The Eustachian tube connects the middle ear with the nasopharynx, rather than the inner ear.

[Feedback for Answer Choice 4] The Eustachian tube connects the middle ear with the nasopharynx, rather than the oval window.

[Q3] As stereocilia are bent, chemical transmitters are released from the cochlear hair cells, and neuroelectric energy is generated and transmitted to auditory nerve fibers that form the acoustic branch of cranial nerve 1.

VII .

2.

VIII . [correct]

3.

IX .

4.

X.

[Feedback for Answer Choice 1] As the stereocilia are bent through the movement of the tectorial and basilar membranes, chemical transmitters are released from the cochlear hair cells, and neuroelectric energy is generated and transmitted to auditory nerve fibers that form the acoustic branch of the vestibulocochlear, or VIIIth cranial nerve. Cranial nerve VII is the facial nerve.

[Feedback for Correct Answer 2] As the stereocilia are bent through the movement of the tectorial and basilar membranes, chemical transmitters are released from the cochlear hair cells, and neuroelectric energy is generated and transmitted to auditory nerve fibers that form the acoustic branch of the vestibulocochlear, or VIIIth cranial nerve.

[Feedback for Answer Choice 3] As the stereocilia are bent through the movement of the tectorial and basilar membranes, chemical transmitters are released from the cochlear hair cells, and 8 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

neuroelectric energy is generated and transmitted to auditory nerve fibers that form the acoustic branch of the vestibulocochlear, or VIIIth cranial nerve. Cranial nerve IX is the glossopharyngeal nerve.

[Feedback for Answer Choice 4] As the stereocilia are bent through the movement of the tectorial and basilar membranes, chemical transmitters are released from the cochlear hair cells, and neuroelectric energy is generated and transmitted to auditory nerve fibers that form the acoustic branch of the vestibulocochlear, or VIIIth cranial nerve. Cranial nerve X is the vagus nerve.

Learning Objective 12.5: Compare and contrast the three different types of hearing loss and related disorders.

[Q1] When is present, the eardrum retracts into the middle ear cavity, reducing its ability to vibrate.

1. positive middle ear pressure 2. otosclerosis 3. stenosis 4. negative middle ear pressure [correct] [Feedback for Answer Choice 1] When negative middle ear pressure is present, the eardrum retracts into the middle ear cavity, reducing its ability to vibrate. If positive middle ear pressure were present, the eardrum would not retract into the middle ear cavity.

[Feedback for Answer Choice 2] When negative middle ear pressure is present, the eardrum retracts into the middle ear cavity, reducing its ability to vibrate. Otosclerosis is the replacement of healthy bone with spongy bone in the area of the stapes footplate, resulting in reduced mobility of the stapes and hearing loss.

[Feedback for Answer Choice 3] When negative middle ear pressure is present, the eardrum retracts into the middle ear cavity, reducing its ability to vibrate. Stenosis is a severe narrowing of the external canal.

[Feedback for Correct Answer 4] When negative middle ear pressure is present, the eardrum retracts into the middle ear cavity, reducing its ability to vibrate.

[Q2]

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A(n) is due to short-term noise exposure and hearing returns to normal, although permanent damage to the cochlea and auditory nerve can be measured.

1. temporary threshold shift [correct] 2. permanent threshold shift 3. loss of cochlear hair cells 4. acoustic neuroma [Feedback for Correct Answer 1] A temporary threshold shift is a temporary hearing loss due to short-term noise exposure; however, even when hearing returns to normal after T TS, permanent damage to the cochlea and auditory nerve can be measured.

[Feedback for Answer Choice 2] A temporary threshold shift is a temporary hearing loss due to short-term noise exposure; however, even when hearing returns to normal after TTS, permanent damage to the cochlea and auditory nerve can be measured. A permanent threshold shift causes a loss of high frequency sensitivity due to frequent high levels of noise.

[Feedback for Answer Choice 3] A temporary threshold shift is a temporary hearing loss due to short-term noise exposure; however, even when hearing returns to normal after TTS, permanent damage to the cochlea and auditory nerve can be measured. Presbycusis is hearing loss that is due to the aging process and is due to the loss of cochlear hair cells, reduced responsiveness of the hair cells, or loss of auditory nerve fibers.

[Feedback for Answer Choice 4] A temporary threshold shift is a temporary hearing loss due to short-term noise exposure; however, even when hearing returns to normal after TTS, permanent damage to the cochlea and auditory nerve can be measured. An acoustic neuroma is a non-malignant growth that develops on the cells near C N VIII .

[Q3] In older individuals, age-related changes can affect both the cochlear hair cells and auditory nerve fibers, resulting in , sometimes even with good amplification.

1. difficulty processing complex language structures 2. reduced speech understanding [correct] 3. otitis media 4. otosclerosis [Feedback for Answer Choice 1]

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In older individuals, age-related changes can affect both the cochlear hair cells and auditory nerve fibers, resulting in reduced speech understanding, sometimes even with good amplification. This does not affect syntactic processing.

[Feedback for Correct Answer 2] In older individuals, age-related changes can affect both the cochlear hair cells and auditory nerve fibers, resulting in reduced speech understanding, sometimes even with good amplification.

[Feedback for Answer Choice 3] In older individuals, age-related changes can affect both the cochlear hair cells and auditory nerve fibers, resulting in reduced speech understanding, sometimes even with good amplification. This does not result in otitis media.

[Feedback for Answer Choice 4] In older individuals, age-related changes can affect both the cochlear hair cells and auditory nerve fibers, resulting in reduced speech understanding, sometimes even with good amplification. This does not result in otosclerosis.

Learning Objective 12.6: Compare and contrast behavioral and non-behavioral methods of audiological assessment.

[Q1] Tympanometry is useful in the diagnosis of 1. auditory neuropathy/dys-synchrony disorder.

2. cochlear pathology.

3. acoustic neuroma.

4. conductive pathology. [correct] [Feedback for Answer Choice 1] Tympanometry is useful in the diagnosis of conductive pathology. It can distinguish between a break in the ossicular chain, otitis media with effusion, or a perforation of the eardrum. It cannot diagnose auditory neuropathy/dys-synchrony disorder.

[Feedback for Answer Choice 2] Tympanometry is useful in the diagnosis of conductive pathology. It can distinguish between a break in the ossicular chain, otitis media with effusion, or a perforation of the eardrum. It cannot diagnose cochlear pathology.

[Feedback for Answer Choice 3] Tympanometry is useful in the diagnosis of conductive pathology. It can distinguish between a break in the ossicular chain, otitis media with effusion, or a perforation of the eardrum. It cannot diagnose acoustic neuroma.

[Feedback for Correct Answer 4] 11 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Tympanometry is useful in the diagnosis of conductive pathology. It can distinguish between a break in the ossicular chain, otitis media with effusion, or a perforation of the eardrum.

[Q2] is/are preferred over behavioral observation when assessing children younger than 5 months of age.

1. Conditioned play audiometry 2. Electroacoustic and electrophysiological measures [correct] 3. Visual reinforcement audiometry 4. Speech recognition thresholds [Feedback for Answer Choice 1] Electroacoustic and electrophysiological measures are preferred when assessing children younger than 5 months of age. Conditioned play audiometry would not be appropriate for this age.

[Feedback for Correct Answer 2] Electroacoustic and electrophysiological measures are preferred when assessing children younger than 5 months of age.

[Feedback for Answer Choice 3] Electroacoustic and electrophysiological measures are preferred when assessing children younger than 5 months of age. Visual reinforcement audiology would not be appropriate for this age.

[Feedback for Answer Choice 4] Electroacoustic and electrophysiological measures are preferred when assessing children younger than 5 months of age. Speech recognition thresholds would not be appropriate for this age.

[Q3] According to this chapter, children with mild hearing losses are at a much greater risk for decreased ability in reading, , and hearing in noise.

1. use of residual hearing 2. use of grammatical markers [correct] 3. mathematics 4. attention to task [Feedback for Answer Choice 1] Children with mild hearing losses are at a much greater risk for decreased ability in reading, use of grammatical markers, and hearing in noise.

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[Feedback for Correct Answer 2] Children with mild hearing losses are at a much greater risk for decreased ability in reading, use of grammatical markers, and hearing in noise.

[Feedback for Answer Choice 3] Children with mild hearing losses are at a much greater risk for decreased ability in reading, use of grammatical markers, and hearing in noise.

[Feedback for Answer Choice 4] Children with mild hearing losses are at a much greater risk for decreased ability in reading, use of grammatical markers, and hearing in noise.

Learning Objective 12.7: Describe three major ways people with hearing loss can be helped.

[Q1] Children who wear hearing aids for greater amounts of time demonstrate 1. Better language skills. [correct] 2. Improved speech articulation.

3. Improved pragmatics, or social language.

4. Improved reading fluency.

[Feedback for Correct Answer 1] Children who wear hearing aids for greater amounts of time demonstrate better language skills.

[Feedback for Answer Choice 2] Children who wear hearing aids for greater amounts of time demonstrate better language skills. Improvements in speech articulation were not included.

[Feedback for Answer Choice 3] Children who wear hearing aids for greater amounts of time demonstrate better language skills. Improvements in pragmatics were not included.

[Feedback for Answer Choice 4] Children who wear hearing aids for greater amounts of time demonstrate better language skills. Improvements in reading fluency were not included.

[Q2] In a cochlear implant, the signal is transmitted across the skin via to the internal receiver-stimulator.

1. sound waves

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2. transverse waves 3. longitudinal waves 4. FM waves [correct] [Feedback for Answer Choice 1] In a cochlear implant, the signal is transmitted across the skin via F M waves to the internal receiver-stimulator and finally to the individual electrodes implanted in the cochlea. The resulting neural impulses are transmitted to the brain in the usual manner.

[Feedback for Answer Choice 2] In a cochlear implant, the signal is transmitted across the skin via F M waves to the internal receiver-stimulator and finally to the individual electrodes implanted in the cochlea. The resulting neural impulses are transmitted to the brain in the usual manner.

[Feedback for Answer Choice 3] In a cochlear implant, the signal is transmitted across the skin via F M waves to the internal receiver-stimulator and finally to the individual electrodes implanted in the cochlea. The resulting neural impulses are transmitted to the brain in the usual manner.

[Feedback for Correct Answer 4] In a cochlear implant, the signal is transmitted across the skin via F M waves to the internal receiver-stimulator and finally to the individual electrodes implanted in the cochlea. The resulting neural impulses are transmitted to the brain in the usual manner.

[Q3] In adults who receive cochlear implants, after the implant.

have poorer speech understanding

1. 1–2% 2. 5–8% [correct] 3. 10–13% 4. 15–18% [Feedback for Answer Choice 1] In adults who receive cochlear implants, 5–8% of recipients have poorer speech understanding after the implant.

[Feedback for Correct Answer 2] In adults who receive cochlear implants, 5–8% of recipients have poorer speech understanding after the implant.

[Feedback for Answer Choice 3] In adults who receive cochlear implants, 5–8% of recipients have poorer speech understanding after the implant.

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[Feedback for Answer Choice 4] In adults who receive cochlear implants, 5–8% of recipients have poorer speech understanding after the implant.

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(b) Chapter 12 Application Exercises Application Exercise 12.1: Describe hearing loss comorbidities.

Learning Objective 12.1: Describe the effects of hearing loss on children and adults.

Reference: Table 12.1 (see page 390) [Q1] Use Table 12.1 (see page 390) to answer the following question: Given the summary of research on hearing loss comorbidities in Table 12.1, describe the comorbidity of depression.

[Q1 Model Response] The likelihood of reporting being depressed increased as degree of hearing loss increased. The prevalence of moderate to severe depression is twice as high in people who report difficulty hearing compared to those who do not.

[Q2] Use Table 12.1 (see page 390) to answer the following question: Given the summary of research on hearing loss comorbidities in Table 12.1, describe the comorbidity of cardiovascular disease.

[Q2 Model Response] Low frequency and flat hearing losses were strongly correlated with cardiovascular disease. Risk of stroke was associated with these hearing losses.

[Q3] Use Table 12.1 (see page 390) to answer the following question: Given the summary of research on hearing loss comorbidities in Table 12.1, describe the comorbidity of cognitive impairment and dementia.

[Q3 Model Response] Use Table 12.1 (see page 390) to answer the following question: As hearing loss increased, the risk of these two conditions increased. Compared to those with normal hearing, people with a moderate hearing loss have three times greater risk of developing these conditions and those with severe losses have almost five times greater risk.

Application Exercise 12.2: Describe personal experience with hearing loss.

Learning Objective 12.5: Compare and contrast the three different types of hearing loss and related disorders.

Reference: Case Study: Terrence (see page 404) and Table 12.2 (see page 405) 16 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

[Q1] Use Case Study: Terrence (see page 404) and Table 12.2 (see page 405) to answer the following question: In the case study of Terrence, how is his hearing loss described?

[Q1 Model Response] Terrence‟s hearing loss is sensorineural in nature, affecting the inner ear. It is also described as congenital because it was present at birth and prelingual because it occurred prior to the development of language.

[Q2] Use Case Study: Terrence (see page 404) and Table 12.2 (see page 405) to answer the following question: Although Terrence‟s sensorineural hearing loss was congenital, other hearing losses may be later developing. Use the information in Table 12.2 to describe later developing hearing loss.

[Q2 Model Response] Later developing hearing losses are not present at birth but show up later in life. For example, a child might be born with a gene mutation that causes hearing loss but the loss might not develop until some point later in life.

[Q3] Use Case Study: Terrence (see page 404) and Table 12.2 (see page 405) to answer the following question: Although Terrence‟s hearing loss was prelingual, other hearing losses can be postlingual. Use Table 12.2 to describe postlingual hearing losses.

[Q3 Model Response] A child with a postlingual sensorineural hearing loss already has some language in place when the hearing loss occurred.

Application Exercise 12.3: Describe personal experience with audiological assessment.

Learning Objective 12.6: Compare and contrast behavioral and non-behavioral methods of audiological assessment.

Reference: Case Study: Terrence (see page 414) [Q1] Use Case Study: Terrence (see page 414) to answer the following question: In this case study, what did the nondiagnostic otoscopy consist of?

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[Q1 Model Response] The audiologist checked to determine that the ear canals were free of any wax or debris that might interfere with testing. She also assessed whether there was evidence of any malformations of the ear and whether both ears were in the correct position on the head.

[Q2] Use Case Study: Terrence (see page 414) to answer the following question: In this case study, what were the results of Terrence‟s behavior observation in the sound treated booth?

[Q2 Model Response] Testing revealed that even when speech and noise stimuli were presented at levels up to 85 dB, Terrence did not provide any observable response.

[Q3] Use Case Study: Terrence (see page 414) to answer the following question: In this case study, what were the results of the auditory brainstem response?

[Q3 Model Response] Terrence‟s hearing thresholds were estimated to be between 90 and 95 dB at these frequencies. Combined with normal tympanograms, Terrence was found to have a profound sensorineural hearing loss in each ear.

18 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

(c) Chapter 12 Test Items 1. Approximately

of the U.S. population has some degree of hearing loss.

a. 5% b. 12% c. 20% d. 53% 2. Approximately

in 1,000 births results in a child with a hearing loss.

a. 1 b. 3 c. 7 d. 10 3. When a person‟s hearing loss reaches considered deaf.

or greater, the person is

a. 60 dB b. 90 dB c. 60 Hz d. 90 Hz 4. Sound is a series of compressions and vibrating source.

that move outward from a

a. rarefactions b. waves c. amplifications d. retractions 5.

is the distance the vibrating object travels in either direction; determines intensity. a. Frequency b. Amplitude c. Pitch d. Wavelength

6. The outer ear consists of the pinna and the

.

a. cerumen b. eustachian tube c. external auditory meatus 19 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

d. nasopharynx 7. In , a child is rewarded for a head-turn response to a sound by an animated or a lighted toy. a. conditioned play audiometry b. pure tone testing c. behavioral observation d. visual reinforcement audiometry 8. The is air-filled, lined with mucous membranes, and includes the opening to the Eustachian tube. a. ear canal b. middle ear space c. nasopharynx d. cochlea 9. The footplate of the stapes rests against the marks the entrance to the inner ear.

, a membrane that

a. oval window b. tympanic membrane c. pinna d. cochlear window 10. The system.

is responsible for providing input to the central auditory

a. auditory cortex b. outer ear c. concha d. cochlea 11. The

is the roof of the organ of Corti.

a. tectorial membrane b. basilar membrane c. stereocilia d. vestibulocochlear nerve 12.

send sound directly to the cochlea and bypass the outer and middle ear. a. Bone conduction hearing aids b. OTC hearing aids 20 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

c. Bimodal hearing aids d. FM systems 13. There is some agreement that receiving cochlear implants prior to results in better outcomes in language and speech. a. 3 months b. 6 months c. 9 months d. 12 months 14. The outer and middle ears comprise the

.

a. sensorineural system b. conductive system c. external auditory system d. external auditory meatus 15. The cochlea and auditory nerve make up the

.

a. sensorineural system b. conductive system c. external auditory system d. upper auditory system 16.

hearing loss results from deformation, malfunction, or obstruction of the outer or middle ear. a. Sensorineural b. Conductive c. Age-related d. Noise-induced

17.

is a complete closure of the auditory canal that results in significant hearing loss. a. Atresia b. Microtia c. Stenosis d. Impacted cerumen

18.

is the replacement of healthy bone with spongy bone in the area of the stapes footplate, resulting in reduced mobility of the stapes and hearing loss. a. Otitis media 21 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

b. Otosclerosis c. Eustachian tube dysfunction d. Myringotomy 19.

is an inflammation of the mucous membrane lining of the middle ear cavity. a. Otitis media b. Otosclerosis c. Myringotomy d. Eustachian tube dysfunction

20. Negative middle ear pressure can cause the eardrum to retract in the middle ear cavity and can lead to the secretion of fluid, known as a. otitis media with effusion. b. purulent otosclerosis. c. suppurative myringotomy. d. eustachian tube dysfunction.

21.

are inserted into the eardrum in children with chronic otitis media to serve the same purpose as the Eustachian tube. a. Cochlear implants b. Hearing aids c. Pressure equalization tubes d. Myringotomy

22.

hearing loss results from the absence, malformation, or damage to the structures of the inner ear. a. Sensorineural b. Conductive c. Age-related d. Noise-induced

23.

is hearing loss due to absence or malformation of inner ear structures during embryonic development. a. Aplasia/dysplasia b. Usher‟s syndrome c. Meniere‟s disease d. Meningitis

24.

is inflammation of the fluids and layers of tissue covering 22 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

the brain. a. Aplasia/dysplasia b. Usher‟s syndrome c. Meniere‟s disease d. Meningitis 25.

is a leading cause of acquired sensorineural hearing loss in young and middle-aged adults. a. Temporary threshold shift b. Noise-induced hearing loss c. Auditory neuropathy spectrum disorder d. Central auditory processing disorder

26.

interfere(s) with the ability to efficiently and effectively use and interpret acoustic information. a. Noise-induced hearing loss b. Presbycusis c. Central auditory processing disorders d. Auditory learning disabilities

27.

are designed to identify significant hearing loss in newborn babies and follow up with prompt audiological intervention services. a. HeadStart programs b. Pediatrician screenings c. Early hearing detection and intervention programs d. Behavioral observations

28. Children who are diagnosed with hearing loss and receive hearing aids and early intervention by develop significantly better language skills. a. 6 months b. 1 year c. 2 years d. 3 years 29. School-age, adolescent, and college-age students are at risk for . a. meningitis b. presbycusis c. noise-induced hearing loss 23 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

d. auditory processing disorders 30. A/an

allows visual inspection of the ear canal and eardrum.

a. tympanometer b. audiometer c. otoscope d. tympanogram 31.

record neuroelectric responses that are generated by the auditory system in response to sound. a. Electroacoustic measures b. Electrophysiological tests c. Acoustic immittance measures d. Otoscopic examinations

32. A/an is a plot representing admittance of the middle ear as a function of changes in air pressure within the ear canal. a. audiometer b. audiogram c. otoscope d. tympanogram 33. A/an is used for selection, manipulation, and presentation of stimuli during hearing assessment. a. tympanometer b. audiometer c. audiogram d. tympanogram 34. In , the audiologist presents a stimulus through a loudspeaker and observes a child‟s reaction. a. behavioral observation b. visual reinforcement audiometry c. pure tone audiometry d. conditioned play audiometry 35.

is one of the fundamental behavioral tests in the standard audiometric assessment; standard practice is to test a range of frequencies from 250 to 8,000 Hz. a. Behavioral observation

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b. Visual reinforcement audiometry c. Pure tone audiometry d. Conditioned play audiometry 36. The stimulus 50% of the time.

is the lowest intensity at which a person can detect a

a. threshold b. baseline c. ceiling d. cut-off score 37.

is intervention aimed at preserving and restoring communication skills that have been negatively impacted by a loss of hearing. a. Hearing aid fitting b. Cochlear implantation c. Aural habilitation/rehabilitation d. Extrinsic device implantation

38. A is a neural prosthesis that bypasses the damaged hair cells of the cochlea and directly stimulates the surviving auditory nerve fibers with electrical energy. a. bone anchored hearing aid b. digital aid c. cochlear implant d. bone conduction hearing aid 39. Children as young as

can undergo cochlear implant surgery.

a. 6 months b. 9 months c. 18 months d. 24 months 40.

are assistive devices used to overcome problems hearing in various situations. a. Hearing assistive technology b. Augmentative communication devices c. Voice output communication devices d. Unaided symbol systems

41. In a/an

, the talker speaks into a microphone attached to a 25 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

transmitter that broadcasts on a designated frequency or channel. a. sound field amplifier b. FM system c. TTY d. cochlear implant 42.

are hand shapes used to visually represent each of the 26 letters of the English alphabet. a. Pidgin Signed English b. Manually Coded English c. Fingerspelling d. American sign language

43. Define the classifications of impairment, disability, and activity limitation.

44. Describe at least two ways children can be affected by various types of hearing loss.

45. Those who are deaf and do not see their deafness as a disability but as a cultural trait are part of the .

46. Name four effects of untreated hearing loss in adults.

47. What are the three primary responsibilities of audiologists?

48. What are the functions of cerumen?

49. Name the components that make up the peripheral auditory system.

50. The the ossicular chain.

,

, and

are the bones of

51. What are the cutoffs for adults and children to consider hearing to be within normal limits?

52. What anatomical structures make up the central auditory system and what is its job?

53. Describe a conductive hearing loss.

54. Describe sensorineural hearing loss and factors that influence the effects of the loss on speech, language, and cognition.

55. What is auditory neuropathy spectrum disorder, what are the effects on hearing, and what are effective treatments?

56. Hearing loss that occurs through the aging process is called

.

57. What are the characteristics of individuals with (central) auditory processing disorder?

58. What are otoacoustic emissions and why are they important?

59. What is the auditory brain stem response and why is it important?

60. Name four communication intervention approaches for children diagnosed with 26 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

severe to profound hearing loss.

61. Describe air conduction and bone conduction and what the comparison of the measures can tell us about hearing loss.

62. Describe the types of speech audiometry (S RT and W RT).

63. Describe the processes of informational counseling and personal adjustment counseling.

64. In most cases, amplification consists of

.

65. What are the physical components of hearing aids?

66. What type of benefit can individuals expect to gain from using hearing aids?

67. What is bimodal hearing?

68. Describe compensatory strategies and direct therapy techniques for C APD.

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(d) Chapter 12 Test Answer Key 1. C (see page 386, section titled “Incidence, Prevalence, Classification, and Impact of Hearing Loss: Children and Adults”) 2. B (see page 386, section titled “Incidence, Prevalence, Classification, and Impact of Hearing Loss: Children and Adults”) 3. B (see page 390, section titled “Deafness, the Deaf Community, and Deaf Culture”) 4. A (see page 395, section titled “Fundamentals of Sound”) 5. B (see page 395, section titled “Fundamentals of Sound”) 6. C (see page 396, section titled “The Outer Ear”) 7. D (see page 415, section titled “Visual Reinforcement Audiology”) 8. B (see page 397, section titled “The Middle Ear”) 9. A (see page 398, section titled “The Middle Ear”) 10. D (see page 398, section titled “The Inner Ear”) 11. A (see page 399, section titled “The Inner Ear”) 12. A (see page 426, section titled “Bone Conduction Hearing Aids”) 13. D (see page 431, section titled “Cochlear Implants in Children”) 14. B (see page 400, section titled “Types of Hearing Loss and Auditory Disorders”) 15. A (see page 400, section titled “Types of Hearing Loss and Auditory Disorders”) 16. B (see page 400, section titled “Conductive Hearing Loss”) 17. A (see page 401, section titled “Disorders of the Outer Ear”) 18. B (see page 402, section titled “Disorders of the Middle Ear”) 19. A (see page 402, section titled “Disorders of the Middle Ear”) 20. A (see page 402, section titled “Disorders of the Middle Ear”) 21. C (see page 403, section titled “Disorders of the Middle Ear”) 22. A (see page 403, section titled “Sensorineural Hearing Loss”) 23. A (see page 404, section titled “Disorders of the Inner Ear”) 24. D (see page 406, section titled “Disorders of the Inner Ear”) 25. B (see page 407, section titled “Disorders of the Inner Ear”) 26. C (see page 409, section titled “(Central) Auditory Processing Disorders”) 27. C (see page 409, section titled “Hearing Loss Through the Lifespan”) 28. A (see page 425, section titled “Hearing Aids in Children”) 29. C (see page 409, section titled “Hearing Loss Through the Lifespan”) 30. C (see page 411, section titled “Otoscopic Examination”) 28 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

31. B (see page 411, section titled “Electroacoustic and Electrophysiological Testing”) 32. D (see page 412, section titled “Electroacoustic and Electrophysiological Testing”) 33. B (see page 413, section titled “Behavioral Testing”) 34. A (see page 414, section titled “Behavioral Observation”) 35. C (see page 415, section titled “Pure Tone Audiometry”) 36. A (see page 415, section titled “Pure Tone Audiometry”) 37. C (see page 422, section titled “Aural (Audiological” Habilitation/Rehabilitation”) 38. C (see page 428, section titled “Cochlear Implants”) 39. B (see page 430, section titled “Cochlear Implants in Children”) 40. A (see page 433, section titled “Hearing Assistive Technology/Assistive Listening Devices”) 41. B (see page 433, section titled “Hearing Assistive Technology/Assistive Listening Devices”) 42. C (see page 393, section titled “Visual Communication Modality”) 43. Answers will vary, but should include the following (see page 387, section titled “Classification of Impairment, Disability, and Handicap”): Impairment is a loss of structure or function. Disability is a term that includes impairment as well as the environmental factors that interfere with functioning.

Activity limitation refers to the functional consequences associated with a particular impairment.

44. Answers will vary, but should include the following (see pages 387–388, section titled “Children”): A child with a profound hearing loss would have no access to the speech sounds in a language without amplification. All degrees of hearing loss can interfere with the ability to succeed in school, both academically and socially. Children with mild hearing loss typically have more difficulty in challenging acoustic environments.

Children with hearing loss must rely more on memory and attention abilities. They are at risk for delayed morphological development. Children with unilateral hearing loss have difficulty localizing sound and hearing in noise.

45. Answers should include the following (see page 390, section titled “Deafness, the Deaf Community, and Deaf Culture”): deaf community 46. Answers should include the following (see page 389, section titled “Adults”): Increased irritability and fatigue due to extra cognitive effort required to process information, increased stress, greater likelihood of becoming isolated, increased risk of injury, reduced earning power and less confidence of ability to perform job duties, reduced self-esteem, overall reduced psychological health.

47. Answers should include the following (see page 393, section titled “What Do 29 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Audiologists Do?”): Conducting hearing screenings; conducting comprehensive hearing assessments; providing a range of intervention services, including the fitting of hearing aids, cochlear implants, and other assistive devices and counseling, aural rehabilitation, and service on a balance team; creating and implementing hearing conservation programs; conducting research on issues related to hearing and balance.

48. Answers will vary, but should include the following (see page 397, section titled “The Outer Ear”): Cerumen protects the ear from foreign bodies and traps dirt and debris, naturally cleansing the external canal as it migrates outward. Cerumen acts as a lubricant to prevent the skin that lines the canal from drying out and serves as a chemical barrier to bacterial and fungal infection.

49. Answers will vary, but should include the following (see page 396, section titled “Anatomy and Physiology of the Auditory System”): Outer ear, middle ear, inner ear, vestibulocochlear nerve 50. Answers should include the following (see page 397, section titled “The Middle Ear”): malleus, incus, stapes 51. Answers should include the following (see page 416, section titled “Degree of Hearing Loss”): 19 dB HL for adults, 15 dB HL for children 52. Answers will vary, but should include the following (see page 400, section titled “The Central Auditory System”): Consists of nuclei, nerve fibers, and nerve tracts; includes pathways that carry auditory information to the brain (ascending) and pathways that receive information from the brain (descending). Anatomical structures leading to the brain ensure that information about the frequency, intensity, and duration of the auditory stimuli remains intact until it reaches the auditory cortex for interpretation.

53. Answers will vary, but should include the following (see page 400, section titled “Conductive Hearing Loss”): Usually prevents low- to moderate-intensity sounds from being heard at all and higher-intensity sounds from being perceived as much softer than normal. Impacts audibility, but does not result in a total loss of hearing. Most are not permanent.

54. Answers will vary, but should include the following (see pages 403–404, section titled “Sensorineural Hearing Loss”): May be present at birth or develop over time, and is usually permanent. Hearing loss is predominately in the higher frequency range. Sounds that are audible are often perceived as being distorted. Factors that influence the effects of the loss on speech, language, and cognition include the degree of the loss, the age of onset, the age of the person when the loss was identified, and the age of the person when appropriate intervention was done. Age of onset is congenital or acquired, or 30 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

prelingual or postlingual.

55. Answers will vary, but should include the following (see page 406, section titled “Disorders of the Inner Ear”): Normal outer hair cell function and abnormal responses from the inner hair cells or auditory nerve fibers. Characterized by a lack of synchrony in the firing of auditory nerve fibers with normal outer hair cell function. May exhibit pure tone hearing within normal limits to profoundly impaired, and usually have considerable difficulty understanding speech even when the pure tone loss is not significant. Hearing aids are helpful to some, but cochlear implants may be more effective.

56. Answers should include the following (see page 408, section titled “Disorders of the Inner Ear”): presbycusis 57. Answers will vary, but should include the following (see page 421, section titled “Auditory Processing Assessment”): May be easily distracted, have difficulty comprehending rapid speech or speech in poor acoustic environments, difficulty following complex auditory directions, difficulty paying attention, slow or inconsistent responses to verbal messages, or increased dependency on visual cues.

58. Answers will vary, but should include the following (see page 412, section titled “Electroacoustic and Electrophysiological Testing”): OAEs are low intensity sounds (echoes) generated within the cochlea as a result of outer hair cell movement; they can be measured with a microphone. When OAEs are present, hearing sensitivity is presumed to be normal or no worse than a mild loss. Important in newborn screening programs.

59. Answers will vary, but should include the following (see page 413, section titled “Electroacoustic and Electrophysiological Testing”): ABR is a type of AEP that measures neuroelectric activity of the auditory nerve and structures of the lower brain stem. ABR can be used to identify neurological issues, such as a tumor on CN VIII or auditory neuropathy/dyssynchrony disorder. Can be used to estimate the auditory thresholds in individuals who are unable or unwilling to be evaluated using behavioral techniques.

60. Answers will vary, but should include the following (see page 431, section titled “Cochlear Implants”): Oral communication methods, total communication, bilingual-bicultural, sign language 61. Answers will vary, but should include the following (see page 417, section titled “Air Conduction and Bone Conduction Testing”): Air conduction testing is administered while a client wears headphones. Bone conduction testing is administered with a bone oscillator, directly stimulating the cochlea. By comparing the results of air conduction testing to bone conduction 31 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

testing, the type of hearing loss can be identified.

62. Answers will vary, but should include the following (see page 419, section titled “Speech Audiometry”): Speech Recognition Threshold is the lowest intensity where a person can recognize approximately 50% of two-syllable words presented. Word Recognition Test assesses how well the client is able to identify one-syllable words presented at some level above threshold.

63. Answers will vary, but should include the following (see page 423, section titled “Counseling”): Informational counseling is the process of giving a client information. Personal adjustment counseling is providing assistance to the client and family in dealing with the emotional consequences of hearing loss.

64. Answers should include the following (see page 424, section titled “Hearing Aids”): personal hearing aids 65. Answers will vary, but should include the following (see page 424, section titled “Hearing Aids”): Microphone, amplifier, receiver, and some type of computer processor 66. Answers will vary, but should include the following (see page 425, section titled “Hearing Aids”): The primary goal is to make speech audible to improve intelligibility. A hearing aid will not return hearing to normal. The client must be counseled so that his/her expectations for improvement are realistic.

67. Answers will vary, but should include the following (see page 430, section titled “Cochlear Implants”): Bimodal hearing is when a cochlear implant is used for one ear and a hearing aid is used for the other ear.

68. Answers will vary, but should include the following (see page 436, section titled “Treatment and Management of (Central) Auditory Processing Disorders”): Compensatory strategies strengthen broader cognitive areas, such as attention and language. Direct therapy consists of intensive auditory training designed to strengthen the specific auditory deficits identified during assessment.

Article XIII. Chapter 13 Test Item File 32 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Introduction to Communication Disorders A Lifespan Evidence-Based Perspective

Seventh Edition

Dr. Robert E. Owens, College of St. Rose Dr. Kimberly A. Farinella, Northern Arizona University

Prepared by

Dr. Sarah A. Dachtyl

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Section 13.01

Table of Contents

Chapter 13: Augmentative and Alternative Communication

1

Learning Objective Quizzes

1

Application Exercises

19

Test Items

22

Test Answer Key

25

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Section 13.02 Chapter 13: Augmentative and Alternative Communication (a) Chapter 13 Learning Objective Quizzes Learning Objective 13.1: Define augmentative and alternative communication (A AC).

[Q1] The term refers to situations in which a system of communication is needed to supplement existing speech.

1. “alternative” 2. “multimodal” 3. “augmentative” [correct] 4. “compensation” [Feedback for Answer Choice 1] The term “augmentative” refers to situations in which a system of communication is needed to supplement existing speech. An alternative means of communication would be necessary in situations where natural speech may be nonfunctional or not present.

[Feedback for Answer Choice 2] The term “augmentative” refers to situations in which a system of communication is needed to supplement existing speech. A multimodal approach to communication incorporates all the different ways a person can communicate.

[Feedback for Correct Answer 3] The term “augmentative” refers to situations in which a system of communication is needed to supplement existing speech.

[Feedback for Answer Choice 4] The term “augmentative” refers to situations in which a system of communication is needed to supplement existing speech. Alternative and augmentative communication (A AC) involves attempts to study and when necessary compensate for temporary or permanent impairment, activity limitations, and participation restrictions of individuals with severe disorders of speech/language production and/or compensation, including spoken and written modes of communication.

[Q2] It is estimated that people worldwide cannot meet their daily communication needs using natural speech.

1. 36 million 2. under 53 million 1 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

3. 75 million 4. over 97 million [correct] [Feedback for Answer Choice 1] It is estimated that 5 million Americans and over 97 million people worldwide cannot meet their daily communication needs using natural speech.

[Feedback for Answer Choice 2] It is estimated that 5 million Americans and over 97 million people worldwide cannot meet their daily communication needs using natural speech.

[Feedback for Answer Choice 3] It is estimated that 5 million Americans and over 97 million people worldwide cannot meet their daily communication needs using natural speech.

[Feedback for Correct Answer 4] It is estimated that 5 million Americans and over 97 million people worldwide cannot meet their daily communication needs using natural speech.

[Q3] Early access to AAC can be vital for adults with degenerating conditions to use in time to record their own voice for their device.

1. synthesized speech 2. voice banking [correct] 3. partner-assisted scanning 4. orthographic methods [Feedback for Answer Choice 1] Early access to AAC can be vital for adults with degenerating conditions to use voice banking in time to record their own voice for their device. Synthesized speech is a computer-generated preprogrammed voice output generated by a speech synthesizer.

[Feedback for Correct Answer 2] Early access to AAC can be vital for adults with degenerating conditions to use voice banking in time to record their own voice for their device.

[Feedback for Answer Choice 3] Early access to AAC can be vital for adults with degenerating conditions to use voice banking in time to record their own voice for their device. Partner-assisted scanning does not include voice recording.

[Feedback for Answer Choice 4]

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Early access to AAC can be vital for adults with degenerating conditions to use voice banking in time to record their own voice for their device. Using orthography is unrelated to voice recording.

Learning Objective 13.2: Explain how interprofessional practice and involvement of communication partners are critical for success.

[Q1] In assessing and providing interventions for people with complex communication needs, the focus should be on and how to connect them with their everyday communication partners.

1. an individual‟s needs and capabilities [correct] 2. the family‟s needs 3. the convenience of the treating therapists 4. the school‟s resources [Feedback for Correct Answer 1] In assessing and providing interventions for people with complex communication needs, the focus should be on an individual‟s needs and capabilities and how to connect them with their everyday communication partners.

[Feedback for Answer Choice 2] In assessing and providing interventions for people with complex communication needs, the focus should be on an individual‟s needs and capabilities and how to connect them with their everyday communication partners.

[Feedback for Answer Choice 3] In assessing and providing interventions for people with complex communication needs, the focus should be on an individual‟s needs and capabilities and how to connect them with their everyday communication partners.

[Feedback for Answer Choice 4] In assessing and providing interventions for people with complex communication needs, the focus should be on an individual‟s needs and capabilities and how to connect them with their everyday communication partners.

[Q2] The establishment of a collaborative team of professionals, working together with the individual and their families 1. is often not possible.

2. takes the focus away from the individual‟s autonomy.

3. is rarely necessary.

4. insures positive outcomes. [correct] 3 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

[Feedback for Answer Choice 1] Although a team approach can be difficult, the establishment of a collaborative team of professionals, working together with the individual and their families, insures positive outcomes.

[Feedback for Answer Choice 2] The establishment of a collaborative team of professionals, working together with the individual and their families, insures positive outcomes, rather than taking the focus away from the individual‟s autonomy.

[Feedback for Answer Choice 3] The establishment of a collaborative team of professionals, working together with the individual and their families, insures positive outcomes.

[Feedback for Correct Answer 4] The establishment of a collaborative team of professionals, working together with the individual and their families, insures positive outcomes.

[Q3] can be used to help formulate client-centered goals that consider multiple needs of the client and environmental factors within an interdisciplinary model.

1. Communicative competence 2. High tech AAC 3. The W HO-ICF [correct] 4. Core vocabulary [Feedback for Answer Choice 1] The W HO-ICF (rather than communicative competence) can be used to help formulate client-centered goals that consider multiple needs of the client and environmental factors within an interdisciplinary model.

[Feedback for Answer Choice 2] The W HO-ICF (rather than high tech AAC) can be used to help formulate clientcentered goals that consider multiple needs of the client and environmental factors within an interdisciplinary model.

[Feedback for Correct Answer 3] The W HO-ICF can be used to help formulate client-centered goals that consider multiple needs of the client and environmental factors within an interdisciplinary model.

[Feedback for Answer Choice 4]

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The W HO-ICF (rather than core vocabulary) can be used to help formulate clientcentered goals that consider multiple needs of the client and environmental factors within an interdisciplinary model.

Learning Objective 13.3: Describe various types of aided and unaided AAC systems, access methods, and AAC output and input.

[Q1] is/are the level that clearly represent(s) the meaning of a symbol.

1. Tangibility 2. Degree of technology 3. Iconicity [correct] 4. Visual scene displays [Feedback for Answer Choice 1] Iconicity is the level that clearly represents the meaning of a symbol, ranging from iconic to transparent to opaque, depending on the clarity of the symbol. Tangible symbols are 3D objects that can be held in your hand.

[Feedback for Answer Choice 2] Iconicity is the level that clearly represents the meaning of a symbol, ranging from iconic to transparent to opaque, depending on the clarity of the symbol. Degree of technology refers to whether the system is no-tech, low-tech, mid-tech, or high-tech.

[Feedback for Correct Answer 3] Iconicity is the level that clearly represents the meaning of a symbol, ranging from iconic to transparent to opaque, depending on the clarity of the symbol.

[Feedback for Answer Choice 4] Iconicity is the level that clearly represents the meaning of a symbol, ranging from iconic to transparent to opaque, depending on the clarity of the symbol. Picture-based systems can be set up in grid-based systems or visual scene displays.

[Q2] Kayla was unable to use direct selection for her high-tech AAC device, so was/were considered.

1. sign language 2. indirect selection methods [correct] 3. manual selection methods 4. written communication [Feedback for Answer Choice 1] 5 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

When direct selection is not an efficient or effective method, indirect selection methods must be considered. Sign language would not likely be appropriate in this case.

[Feedback for Correct Answer 2] When direct selection is not an efficient or effective method, indirect selection methods must be considered.

[Feedback for Answer Choice 3] When direct selection is not an efficient or effective method, indirect selection methods must be considered. Manual selection is another term for direct selection.

[Feedback for Answer Choice 4] When direct selection is not an efficient or effective method, indirect selection methods must be considered. Written communication would not likely be appropriate in this case.

[Q3] New technology has developed ways to use to sense the electrical activity during the activation of a muscle to control a switch.

1. electroencephalography 2. evoked potentials 3. nerve conduction studies 4. electromyography [correct] [Feedback for Answer Choice 1] New technology has developed ways to use electromyography to sense the electrical activity during the activation of a muscle to control a switch. Electroencephalography is specific to the brain rather than muscle.

[Feedback for Answer Choice 2] New technology has developed ways to use electromyography to sense the electrical activity during the activation of a muscle to control a switch. Evoked potentials are not used to activate a switch.

[Feedback for Answer Choice 3] New technology has developed ways to use electromyography to sense the electrical activity during the activation of a muscle to control a switch. Nerve conduction studies are used to diagnose pathology.

[Feedback for Correct Answer 4] New technology has developed ways to use electromyography to sense the electrical activity during the activation of a muscle to control a switch.

Learning Objective 13.4: Dispel myths surrounding AAC. [Q1] 6 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Which of the following is a myth about the use of AAC? 1. Use of AAC input supports development of language skills.

2. Speech-generating devices are only for those with intact cognition. [correct] 3. AAC systems can allow for both digitized and synthesized speech.

4. An individual‟s access methods can change over time.

[Feedback for Answer Choice 1] Myths include: AAC is a “last resort” in speech/language intervention, AAC hinders or stops further speech development, a person must have a certain set of skills to benefit from AAC, SGDs are only for those with intact cognition, children must be of a certain age to be able to benefit from AAC, there is a representational hierarchy of symbols from objects to written words, AAC cannot be embedded in natural routines, AAC systems place undue stress on families, SGDs are too difficult for families to use with their child, AAC is only for communication partners other than the immediate family, and AAC should not be a priority for early intervention.

[Feedback for Correct Answer 2] Myths include: AAC is a “last resort” in speech/language intervention, AAC hinders or stops further speech development, a person must have a certain set of skills to benefit from AAC, SGDs are only for those with intact cognition, children must be of a certain age to be able to benefit from AAC, there is a representational hierarchy of symbols from objects to written words, AAC cannot be embedded in natural routines, AAC systems place undue stress on families, SGDs are too difficult for families to use with their child, AAC is only for communication partners other than the immediate family, and AAC should not be a priority for early intervention.

[Feedback for Answer Choice 3] Myths include: AAC is a “last resort” in speech/language intervention, AAC hinders or stops further speech development, a person must have a certain set of skills to benefit from AAC, SGDs are only for those with intact cognition, children must be of a certain age to be able to benefit from AAC, there is a representational hierarchy of symbols from objects to written words, AAC cannot be embedded in natural routines, AAC systems place undue stress on families, SGDs are too difficult for families to use with their child, AAC is only for communication partners other than the immediate family, and AAC should not be a priority for early intervention.

[Feedback for Answer Choice 4] Myths include: AAC is a “last resort” in speech/language intervention, AAC hinders or stops further speech development, a person must have a certain set of skills to benefit from AAC, SGDs are only for those with intact cognition, children must be of a certain age to be able to benefit from AAC, there is a representational hierarchy of symbols from objects to written words, AAC cannot be embedded in natural routines, AAC systems place undue stress on families, SGDs are too difficult for families to use with their child, AAC is only for communication partners other than the immediate family, and AAC should not be a priority for early intervention.

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[Q2] Which of the following is a myth about the use of AAC? 1. AAC systems place undue stress on families. [correct] 2. Digitized or synthesized speech should be age-appropriate and matched to the individual‟s gender identity.

3. Semantic compaction can increase efficiency.

4. We all use multiple modes of communication in our daily lives.

[Feedback for Correct Answer 1] Myths include: AAC is a “last resort” in speech/language intervention, AAC hinders or stops further speech development, a person must have a certain set of skills to benefit from AAC, SGDs are only for those with intact cognition, children must be of a certain age to be able to benefit from AAC, there is a representational hierarchy of symbols from objects to written words, AAC cannot be embedded in natural routines, AAC systems place undue stress on families, SGDs are too difficult for families to use with their child, AAC is only for communication partners other than the immediate family, and AAC should not be a priority for early intervention.

[Feedback for Answer Choice 2] Myths include: AAC is a “last resort” in speech/language intervention, AAC hinders or stops further speech development, a person must have a certain set of skills to benefit from AAC, SGDs are only for those with intact cognition, children must be of a certain age to be able to benefit from AAC, there is a representational hierarchy of symbols from objects to written words, AAC cannot be embedded in natural routines, AAC systems place undue stress on families, SGDs are too difficult for families to use with their child, AAC is only for communication partners other than the immediate family, and AAC should not be a priority for early intervention.

[Feedback for Answer Choice 3] Myths include: AAC is a “last resort” in speech/language intervention, AAC hinders or stops further speech development, a person must have a certain set of skills to benefit from AAC, SGDs are only for those with intact cognition, children must be of a certain age to be able to benefit from AAC, there is a representational hierarchy of symbols from objects to written words, AAC cannot be embedded in natural routines, AAC systems place undue stress on families, SGDs are too difficult for families to use with their child, AAC is only for communication partners other than the immediate family, and AAC should not be a priority for early intervention.

[Feedback for Answer Choice 4] Myths include: AAC is a “last resort” in speech/language intervention, AAC hinders or stops further speech development, a person must have a certain set of skills to benefit from AAC, SGDs are only for those with intact cognition, children must be of a certain age to be able to benefit from AAC, there is a representational hierarchy of symbols from objects to written words, AAC cannot be embedded in natural routines, AAC 8 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

systems place undue stress on families, SGDs are too difficult for families to use with their child, AAC is only for communication partners other than the immediate family, and AAC should not be a priority for early intervention.

[Q3] Which of the following is a myth about the use of AAC? 1. A symbol does not need a certain level of iconicity for an individual to learn its use.

2. Picture communication can be portable and wearable on a lanyard or around the wrist.

3. Sign language can be used by communication partners as AAC input to aid comprehension.

4. Spoken communication is the only real communication. [correct] [Feedback for Answer Choice 1] Myths include: AAC is a “last resort” in speech/language intervention, AAC hinders or stops further speech development, a person must have a certain set of skills to benefit from AAC, SGDs are only for those with intact cognition, children must be of a certain age to be able to benefit from AAC, there is a representational hierarchy of symbols from objects to written words, AAC cannot be embedded in natural routines, AAC systems place undue stress on families, SGDs are too difficult for families to use with their child, AAC is only for communication partners other than the immediate family, and AAC should not be a priority for early intervention.

[Feedback for Answer Choice 2] Myths include: AAC is a “last resort” in speech/language intervention, AAC hinders or stops further speech development, a person must have a certain set of skills to benefit from AAC, SGDs are only for those with intact cognition, children must be of a certain age to be able to benefit from AAC, there is a representational hierarchy of symbols from objects to written words, AAC cannot be embedded in natural routines, AAC systems place undue stress on families, SGDs are too difficult for families to use with their child, AAC is only for communication partners other than the immediate family, and AAC should not be a priority for early intervention.

[Feedback for Answer Choice 3] Myths include: AAC is a “last resort” in speech/language intervention, AAC hinders or stops further speech development, a person must have a certain set of skills to benefit from AAC, SGDs are only for those with intact cognition, children must be of a certain age to be able to benefit from AAC, there is a representational hierarchy of symbols from objects to written words, AAC cannot be embedded in natural routines, AAC systems place undue stress on families, SGDs are too difficult for families to use with their child, AAC is only for communication partners other than the immediate family, and AAC should not be a priority for early intervention.

[Feedback for Correct Answer 4] 9 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Myths include: AAC is a “last resort” in speech/language intervention, AAC hinders or stops further speech development, a person must have a certain set of skills to benefit from AAC, SGDs are only for those with intact cognition, children must be of a certain age to be able to benefit from AAC, there is a representational hierarchy of symbols from objects to written words, AAC cannot be embedded in natural routines, AAC systems place undue stress on families, SGDs are too difficult for families to use with their child, AAC is only for communication partners other than the immediate family, and AAC should not be a priority for early intervention.

Learning Objective 13.5: Explain how an AAC assessment is dynamic, collaborative, and ongoing.

[Q1] Two models of assessment in AAC include communicative competencies.

and

1. the participation model [correct] 2. the opportunities and barriers model 3. the social networks model 4. the linguistic competence model [Feedback for Correct Answer 1] Two models of assessment in AAC include the participation model and communicative competencies.

[Feedback for Answer Choice 2] Two models of assessment in AAC include the participation model and communicative competencies. The participation model provides a framework for assessing the individual‟s capabilities and access barriers as well as the opportunity barriers that hinder the individual‟s abilities to participate that exist relating to policies, practice, knowledge, skills, or attitudes of others.

[Feedback for Answer Choice 3] Two models of assessment in AAC include the participation model and communicative competencies. The social networks model is a foil; however, the Social Networks Communication Inventory helps to create a profile of the individual and their relationships with communication partners extending out from the families or life partners to friends and acquaintances, to those who are paid to work with the individual, to people in the community.

[Feedback for Answer Choice 4] Two models of assessment in AAC include the participation model and communicative competencies. The linguistic competence model is a foil; however, linguistic competence is an individual‟s language ability across all components of language.

[Q2] 10 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

can yield information on how an individual best responds or provide an understanding of the level of scaffolded support that might be used in treatment.

1. Criterion-referenced assessment 2. Modified standardized assessment 3. Dynamic assessment [correct] 4. Standardized assessment [Feedback for Answer Choice 1] Dynamic assessment can yield information on how the individual best responds or provide an understanding of the level of scaffolded support that might be used in treatment. Criterion-referenced assessments allow for collection of baseline measurements for understanding the individual‟s communicative intent and variety of communicative functions expressed.

[Feedback for Answer Choice 2] Dynamic assessment can yield information on how the individual best responds or provide an understanding of the level of scaffolded support that might be used in treatment. Modified standardized assessments are not likely to yield this specific information.

[Feedback for Correct Answer 3] Dynamic assessment can yield information on how the individual best responds or provide an understanding of the level of scaffolded support that might be used in treatment.

[Feedback for Answer Choice 4] Dynamic assessment can yield information on how the individual best responds or provide an understanding of the level of scaffolded support that might be used in treatment. Standardized assessments are often not appropriate for this population and cannot yield this specific information.

[Q3] Factors that contribute to adjusting the system, and lack of support.

include poor fit, not maintaining or

1. poor literacy 2. device abandonment [correct] 3. AAC myths 4. a lack of speech development [Feedback for Answer Choice 1]

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Factors that contribute to device abandonment include poor fit, attitude, not maintaining or adjusting the system, lack of training, attitudes of those around the individual, and lack of support.

[Feedback for Correct Answer 2] Factors that contribute to device abandonment include poor fit, attitude, not maintaining or adjusting the system, lack of training, attitudes of those around the individual, and lack of support.

[Feedback for Answer Choice 3] Factors that contribute to device abandonment include poor fit, attitude, not maintaining or adjusting the system, lack of training, attitudes of those around the individual, and lack of support.

[Feedback for Answer Choice 4] Factors that contribute to device abandonment include poor fit, attitude, not maintaining or adjusting the system, lack of training, attitudes of those around the individual, and lack of support.

Learning Objective 13.6: Apply communicative competencies to intervention practices with individuals with complex communication needs and their communication partners.

[Q1] If those around the individual opportunities in a variety of contexts to learn.

, the individual will have more

1. use AAC [correct] 2. use least-to-most prompts 3. adapt toys to be activated via switch 4. add new vocabulary to the device [Feedback for Correct Answer 1] If those around the individual use AAC and model language by “speaking AAC,” the individual will have more opportunities in a variety of contexts to learn.

[Feedback for Answer Choice 2] If those around the individual use AAC and model language by “speaking AAC,” the individual will have more opportunities in a variety of contexts to learn. Use of prompt hierarchies is important but does not necessarily result in more opportunities.

[Feedback for Answer Choice 3] If those around the individual use AAC and model language by “speaking AAC,” the individual will have more opportunities in a variety of contexts to learn. Adapting toys to be activated by switches can be a first step to teach individuals they have the power to control their world.

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[Feedback for Answer Choice 4] If those around the individual use AAC and model language by “speaking AAC,” the individual will have more opportunities in a variety of contexts to learn. Adding new vocabulary to the device can be important but does not necessarily result in more opportunities.

[Q2] Veda‟s SLP structures her AAC intervention to target functional contexts, and involves multiple communication partners.

, in

1. decontextualized language 2. hand-under-hand prompting 3. meaningful language [correct] 4. prompt dependency [Feedback for Answer Choice 1] AAC intervention needs to target meaningful vocabulary/language, in functional contexts, and involve multiple communication partners throughout the individual‟s day.

Decontextualized language is less meaningful.

[Feedback for Answer Choice 2] AAC intervention needs to target meaningful vocabulary/language, in functional contexts, and involve multiple communication partners throughout the individual‟s day.

Hand-under-hand prompting is not an intervention target.

[Feedback for Correct Answer 3] AAC intervention needs to target meaningful vocabulary/language, in functional contexts, and involve multiple communication partners throughout the individual‟s day.

[Feedback for Answer Choice 4] AAC intervention needs to target meaningful vocabulary/language, in functional contexts, and involve multiple communication partners throughout the individual‟s day.

Prompt dependency is to be avoided.

[Q3] Individuals learning to use AAC need to increase their communicative competencies to become effective communicators.

1. consultative therapy 2. 30 minutes of treatment per week 3. 60 minutes of treatment per week 4. direct intervention [correct] [Feedback for Answer Choice 1] 13 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Individuals learning to use AAC need direct intervention to increase their communicative competencies to become effective communicators. Consultative therapy is not direct and would not result in the same outcomes.

[Feedback for Answer Choice 2] Individuals learning to use AAC need direct intervention to increase their communicative competencies to become effective communicators. The number of therapy minutes per week should be individualized.

[Feedback for Answer Choice 3] Individuals learning to use AAC need direct intervention to increase their communicative competencies to become effective communicators. The number of therapy minutes per week should be individualized.

[Feedback for Correct Answer 4] Individuals learning to use AAC need direct intervention to increase their communicative competencies to become effective communicators.

Learning Objective 13.7: Describe how intervention can foster language development and independence through use of supportive prompt hierarchies, adaptive play skills, focused and functional intervention, and development of literacy skills.

[Q1] can help an individual academically, provide a foundation for future employment, and ensure access to improved healthcare.

1. Individualized vocabulary 2. Literacy [correct] 3. Device customization 4. Semantic compaction [Feedback for Answer Choice 1] Literacy can help an individual academically, provide a foundation for future employment, ensure access to improved healthcare, improve interactions with a wider community to build relationships, and improve their overall independence.

[Feedback for Correct Answer 2] Literacy can help an individual academically, provide a foundation for future employment, ensure access to improved healthcare, improve interactions with a wider community to build relationships, and improve their overall independence.

[Feedback for Answer Choice 3] Literacy can help an individual academically, provide a foundation for future employment, ensure access to improved healthcare, improve interactions with a wider community to build relationships, and improve their overall independence.

14 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

[Feedback for Answer Choice 4] Literacy can help an individual academically, provide a foundation for future employment, ensure access to improved healthcare, improve interactions with a wider community to build relationships, and improve their overall independence.

[Q2] can give the individual access to the most frequently used words in conversation.

1. Language promotion strategies 2. Verbal modeling 3. A core vocabulary approach [correct] 4. Aided language stimulation [Feedback for Answer Choice 1] A core vocabulary approach can give the individual access to the most frequently used words in conversation. Language promotion strategies are a foil; however, strategies that promote language development can also promote language development with AA C. [Feedback for Answer Choice 2] A core vocabulary approach can give the individual access to the most frequently used words in conversation. Verbal modeling is provided for development of speech, whereas aided language stimulation can provide the modeling of AAC in the “language” of the individual.

[Feedback for Correct Answer 3] A core vocabulary approach can give the individual access to the most frequently used words in conversation.

[Feedback for Answer Choice 4] A core vocabulary approach can give the individual access to the most frequently used words in conversation. Aided language stimulation can provide the modeling of AAC in the “language” of the individual.

[Q3] Use of any physical, hand-over-hand, or hand-under-hand prompting can lead to 1. more meaningful intervention.

2. rapid gains in independent communication skills.

3. improved language function.

4. prompt dependency. [correct] 15 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

[Feedback for Answer Choice 1] Use of any physical, hand-over-hand, or hand-under-hand prompting can lead to prompt dependency. Physical prompts can also lead to control of the individual‟s message rather than their own intent.

[Feedback for Answer Choice 2] Use of any physical, hand-over-hand, or hand-under-hand prompting can lead to prompt dependency. Physical prompts do not lead to independent communication.

[Feedback for Answer Choice 3] Use of any physical, hand-over-hand, or hand-under-hand prompting can lead to prompt dependency rather than improved language function.

[Feedback for Correct Answer 4] Use of any physical, hand-over-hand, or hand-under-hand prompting can lead to prompt dependency.

Learning Objective 13.8: Understand how the Communication Bill of Rights guides advocacy and goals for AAC. [Q1] is a basic human right.

1. Access to speech/language therapy 2. Alternative and augmentative communication 3. Literacy 4. Communication [correct] [Feedback for Answer Choice 1] Communication is a basic human right.

[Feedback for Answer Choice 2] Communication is a basic human right.

[Feedback for Answer Choice 3] Communication is a basic human right.

[Feedback for Correct Answer 4] Communication is a basic human right.

[Q2] In , the National Joint Commission for the Communication Needs of People with Severe Disabilities reviewed and updated the Communication Bill of Rights.

1. 1998 16 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

2. 2008 3. 2010 4. 2016 [correct] [Feedback for Answer Choice 1] In 2016 the National Joint Commission for the Communication Needs of People with Severe Disabilities reviewed and updated the Communication Bill of Rights.

[Feedback for Answer Choice 2] In 2016 the National Joint Commission for the Communication Needs of People with Severe Disabilities reviewed and updated the Communication Bill of Rights.

[Feedback for Answer Choice 3] In 2016 the National Joint Commission for the Communication Needs of People with Severe Disabilities reviewed and updated the Communication Bill of Rights.

[Feedback for Correct Answer 4] In 2016 the National Joint Commission for the Communication Needs of People with Severe Disabilities reviewed and updated the Communication Bill of Rights.

[Q3] The Communication Bill of Rights notes that all people with a disability have a basic right to effect, through communication, 1. the conditions of their existence. [correct] 2. the actions of others.

3. the feelings of those around them.

4. their opinions.

[Feedback for Correct Answer 1] The Communication Bill of Rights notes that all people with a disability have a basic right to effect, through communication, the conditions of their existence.

[Feedback for Answer Choice 2] The Communication Bill of Rights notes that all people with a disability have a basic right to effect, through communication, the conditions of their existence, rather than the actions of others.

[Feedback for Answer Choice 3] The Communication Bill of Rights notes that all people with a disability have a basic right to effect, through communication, the conditions of their existence, rather than the feelings of those around them.

[Feedback for Answer Choice 4] 17 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

The Communication Bill of Rights notes that all people with a disability have a basic right to effect, through communication, the conditions of their existence, rather than solely their opinions.

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(b) Chapter 13 Application Exercises Application Exercise 13.1: Describe personal experiences with AAC. Learning Objective 13.2: Explain how interprofessional practice and involvement of communication partners are critical for success.

Reference: Pearson e-Text Video Example 13.1 [Q1] Use Pearson e-Text Video Example 13.1 to answer the following question: In this video, what does Maya‟s mother say about how important it is for others to know that Maya uses a communication device?

[Q1 Model Response] She said that Maya was able to report to the principal how she was injured at school and who she was with at the time. In addition, every person who works with Maya knows she has the words and ability to tell others about their interactions with her, and that shapes how they interact with her.

[Q2] Use Pearson e-Text Video Example 13.1 to answer the following question: How did Maya come to obtain a communication device. What could have been different if the professionals working with Maya had mentioned AAC? [Q2 Model Response] Maya‟s mother learned about AAC on her own despite seeing doctors and multiple speech-language pathologists. Earlier intervention could have resulted in even more positive results and earlier communication.

[Q3] Use Pearson e-Text Video Example 13.1 to answer the following question: What is a goal Maya‟s mother believes that the AAC field should strive toward?

[Q3 Model Response] To increase AAC awareness among pediatric medical and therapy providers, particularly those who work with children with disabilities.

Application Exercise 13.2: Describe an individual‟s communication output.

Learning Objective 13.3: Describe various types of aided and unaided AAC systems, access methods, and AAC output and input.

Reference: Case Study: Naveen (pages 449 and 451) [Q1] 19 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

Use Case Study: Naveen (pages 449 and 451) to answer the following question: In this case study, how did Naveen communicate prior to his parents‟ purchase of an iPad and communication app?

[Q1 Model Response] Naveen‟s attempt at communication included emotional responses, reaching toward people or objects, and facial expressions. His mother often anticipated his needs.

[Q2] Use Case Study: Naveen (pages 449 and 451) to answer the following question: When object choice was introduced, how did Naveen react?

[Q2 Model Response] Naveen initially reacted with discontent because he perceived that there was a delay in getting the object he wanted or that it was being denied to him.

[Q3] Use Case Study: Naveen (pages 449 and 451) to answer the following question: Naveen used his own modified signs to communicate. What are important principles to be aware of in these scenarios?

[Q3 Model Response] It is important for everyone around them to understand the individual‟s unique way of communicating. A personal “dictionary” of modified signs and other signals can be made and included in reports or training materials so staff working with the individual can understand their communication attempts.

Application Exercise 13.3: Discuss supports available for developing communication skills for AAC users.

Learning Objective 13.7: Describe how intervention can foster language development and independence through use of supportive prompt hierarchies, adaptive play skills, focused and functional intervention, and development of literacy skills.

Reference: Pearson e-Text Video Example 13.8 [Q1] Use Pearson e-Text Video Example 13.8 to answer the following question: In this video, aided language stimulation is explained. For Josie, what was the effect on her communication when those around her used spoken language modeling?

[Q1 Model Response] As she grew older, she did not learn to speak. Speaking did not work as a model for teaching her how to communicate.

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[Q2] Use Pearson e-Text Video Example 13.8 to answer the following question: After she was given a communication device, she needed help to learn language. What worked for her?

[Q2 Model Response] When those around her used her device to model language frequently, it helped Josie learn language to communicate.

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(c) Chapter 13 Test Items 1. Approximately people in the United States are not able to use natural speech to express their wants and needs and may benefit from AAC. a. 100,000 b. 500,000 c. 2 million d. 5 million 2.

involve only using your body to communicate. a. Unaided systems b. Aides systems c. Tangible symbols d. Pictorial symbols

3. A approach to communication incorporates all the different ways a person can communicate. a. multimodal b. functional c. dynamic d. habilitative 4.

signs are easily guessable, explainable, and memorable. a. Iconic b. Transparent c. Opaque d. Equivalent

5.

are 3D objects used for communication purposes that can be held in your hand. a. Dynamic symbols b. Visual scenes c. Iconic symbols d. Tangible symbols

6. Aided AAC systems are grouped as a. no-tech, low-tech, mid-tech, or high-tech. b. manual or automatic. c. digital or synthetic.

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d. dynamic or transparent.

7.

can allow an individual to generate their own unique thoughts and words. a. Alphabetic symbols b. Visual scene displays c. Visual schedules d. Transparent symbols

8.

is an access method in which individuals may select an item by touching, taking, or pointing to an item or symbol to indicate a message. a. Direct selection b. Indirect selection c. Scanning d. Auditory scanning

9.

is an access method that involves the client assembling a message through a series of switch activations in which choices are presented sequentially. a. Direct selection b. Indirect selection c. Scanning d. Auditory scanning

10.

is/are ways that an individual can select a message or access a symbol. a. CCN b. Access methods c. Voice banking d. AAC input is an individual‟s language ability across all dimensions of

11. language.

a. Operational competence b. Strategic competence c. Linguistic competence d. Device competence 12.

can help decrease negative behaviors by supporting increased understanding of transitions through use of visual or object schedules. a. AAC output 23 Copyright © 2024, 2019, 2015 by Pearson Education, Inc. All rights reserved.

b. Digitized speech c. Synthesized speech d. AAC input 13. The order of teaching signs or symbols must be guided by a. the way the device is organized. b. the school‟s recommendations. c. research recommendations that suggest biographical information should be taught first. d. the individual‟s identified needs and priorities.

14. Use of is/are not valid for this population but can yield information to determine a capabilities profile. a. dynamic assessment b. observations c. standardized tests d. criterion-based assessments 15. Just as verbal modeling is provided for development of speech, can provide the modeling of AAC in the “language” of the individual. a. direct selection b. partner-assisted scanning c. direct intervention d. aided language stimulation 16. Briefly define alternative and augmentative communication (AAC).

17. Name two benefits of object or picture (no-tech) communication systems.

18. Compare and contrast digitized and synthesized speech.

19. Briefly summarize the main points of the Communication Bill of Rights.

20. What is social competence?

21. Discuss factors related to AAC system selection (feature matching).

22. Name three factors that contribute to device abandonment.

23. Name four AAC myths.

24. Describe the Participation Model as it relates to AAC assessment.

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(d) Chapter 13 Test Answer Key 1. D (see page 445, section titled “Who Can Benefit from the Use of AAC?”) 2. A (see page 448, section titled “Types of Augmentative and Alternative Communication”) 3. A (see page 443, section titled “Defining Augmentative and Alternative Communication (AAC)”) 4. B (see page 453, section titled “Symbolic Representation of Aided Symbols”) 5. D (see page 454, section titled “Aided Symbols: Tangible Symbols”) 6. A (see page 452, section titled “Aided AAC Communication Systems”) 7. A (see page 455, section titled “Aided Symbols: Orthography and Orthographic Print Symbols”) 8. A (see page 457, section titled “Direct Selection”) 9. C (see pages 457–458, section titled “Indirect Selection: Scanning”) 10. B (see page 457, section titled “AAC Access Methods”) 11. C (see page 464, section titled “Communicative Competencies”) 12. D (see page 459, section titled “AAC Input”) 13. D (see page 471, section titled “Where to Start?: Team-Based Intervention and Communication Partners”) 14. C (see page 468, section titled “Specific Assessment Considerations”) 15. D (see page 472, section titled “Supporting Language Development and Independence”) 16. Answers will vary, but should include the following (see page 443, section titled “Defining Augmentative and Alternative Communication (AAC)”): AAC is anything that supplements an existing communication system.

17. Answers will vary, but should include the following (see page 452, section titled “Aided AAC Communication Systems”): Object or picture communication can be useful to provide AAC input to help an individual follow a visual schedule and are helpful in classrooms and work environments. Picture communication can be portable and wearable on a lanyard or around the wrist. No-tech AAC can be used in environments that might not be tech friendly.

18. Answers will vary, but should include the following (see page 459, section titled “AA C Output”): Digitized speech is recorded speech placed on the device. Synthesized speech is computer-generated preprogrammed voice output generated by a speech synthesizer.

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19. Answers will vary, but should include the following (see page 477, section titled “Advocacy: Communication Bill of Rights”): It notes that all people with a disability of any extent or severity have a basic right to effect, through communication, the conditions of their existence. Beyond this general right, a number of specific communication rights should be ensured in all daily interactions and interventions involving persons who have severe disabilities.

20. Answers will vary, but should include the following (see page 465, section titled “Communicative Competencies”): Relates to how well a person manages the social aspects of communication, such as turn taking, topic maintenance, and using balanced and reciprocal interactions.

21. Answers will vary, but should include the following (see page 470, section titled “AA C System Selection or Feature Matching”): Access to vocabulary, message characteristics including design of display/symbol system, portability and mobility, access method, output method, access to literacy.

22. Answers will vary, but should include the following (see page 469, section titled “Areas of Assessment for Access to AAC”): Poor fit, attitude, not maintaining or adjusting the system, lack of training, lack of support, and attitudes of those around the individual.

23. Answers will vary, but should include the following (see pages 460–462, sections titled “Myths Impacting AAC: Early Intervention” and “Myths about Adult Communicators and AAC”): AAC is a “last resort” in speech-language intervention. AAC hinders or stops further speech development. A person must have a certain set of skills to benefit from AAC. SGDs are only for those with intact cognition. Children must be of a certain age to be able to benefit from AAC. There is a representational hierarchy of symbols from objects to written words. AAC cannot be embedded in natural routines. AAC systems place undue stress on families. SGDs are too difficult for families to use with their child. AAC is only for communication partners other than the immediate family. AAC should not be a priority for early intervention. Working on communication is not worth the effort. If communication, language, or literacy intervention didn‟t work in childhood, they won‟t work now. Adults with severe disabilities have simple thoughts, feelings, and understandings, so they do not need comprehensive services or supports. Spoken communication is the only real communication.

24. Answers will vary, but should include the following (see page 463, section titled “The Participation Model”): This model examines the environment and participation patterns of the individual as well as peers to determine supports provided and needed. It provides a framework for assessing the individual‟s capabilities and access barriers as well as the opportunity barriers that hinder the individual‟s abilities to participate that exist relating to policies, practice, knowledge, skills, or attitudes of others.

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