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1. A 3 year 6 month male is referred to your clinic with the diagnosis “oral motor problems”. You notice he is not drooling, can chew a cookie well and has a symmetrical smile. He has no functional speech, but you notice a strong “da”‘ and “ta”. He can yell and has good phonation. What are your initial hypotheses? Option A This child has execution deficits involving coordination of speech movements. Option B This child has a dysarthria characterized by respiratory incoordination and reduced vital capacity. Option C This child is weak and has dysarthria. Option D This child is more likely to have a speech delay, phonologic impairment or CAS, but is not dysarthric. 2. Your colleague describes a new client who exhibited a Standard Score of 40 on an articulation test, making numerous consistent substitution and omission errors, including /t/ for /k/; /d/ for /g/; /f/ or /v/ for /th/; /t/ for /s/ and /sh/; /d/ for /z/; consistent /w/ for /r/ and consistent vocalic /r/ distortions. All other substitution errors are produced with accurate but substituted sounds, and are consistent across trials. He exhibits normal receptive and expressive language as well as normal pragmatic language. Where does this child’s impairment fall in a model of speech production? Option A Under the second level: Linguistic Processing Option B Under the first level; cognitive impairment Option C Under the fourth level: Motor Execution 3. A student has come to do a school or clinic placement with you for one semester. During her second week she tells you she has heard a talk about “diagnostic markers”. Her question to you is: “What does this term mean and how should I use it in this setting?” You respond: Option A You tell her that both physiologic and behavioral markers must be present to make a speech diagnosis. Option B You tell her that diagnostic markers relate to levels of proficiency in making differential diagnoses. Option C You tell her that “diagnostic markers” are physiological or behavioral characteristics associated with a particular disease or disorder. For speech sound disorders we rely on behavioral markers. Option D You tell her this relates to the way she should be marking forms related to diagnostic billing. 4.A child presents with low average receptive language, but poor expressive language. He exhibits poor intelligibility due to numerous vowel distortions; difficulty achieving articulation configurations; inconsistent voicing errors; groping and trial and error behavior during the motor speech exam; syllable segregation and frequent use of equal stress; and inconsistency in production over repeated trials. His performance on the structural-functional exam was normal and there is no problem with respiration or phonation. He frequently initiates functional communication, establishes good eye contact and is consistently responsive. What is the most likely appropriate label for this child’s speech disorder? Option A Apraxia of Speech Option B Phonologic impairment Option C Dysarthria Option D Pragmatic Language Deficit 5. A 6-year-old child with a severe speech sound disorder and poor intelligibility comes to you for assessment of his speech sound disorder. His language has been recently and thoroughly tested at school showing average receptive and expressive language. Due to very poor articulation, he has been referred for further speech assessment. He is cooperative, with good attention, normal cognition and good pragmatics. What would you include in your assessment session? Option A A more thorough cognitive assessment to make sure intellectual dysfunction is not contributing to his speech disorder. Option B All standardized speech assessments currently available. Option C A spontaneous speech sample, an articulation test; a structural functional examination; and a motor speech examination that provides dynamic cueing. Option D Receptive and expressive language testing; a phonologic exam; and an articulation test. 6.You have been asked to give a lecture to first year graduate students in speech pathology. They have asked you to focus on the goals and procedures for the structural functional examination. How would you describe the procedures involved if your objective was to emphasis the purposes and goals of the structural functional examination? Option A Focus on the observation of muscle tone, making judgments regarding the presence and severity of low tone. Option B Describe the procedures for determining range of motion, strength and speed of movement of the oral mechanism in a non -speech context; follow this by describing how to elicit volitional non-speech oral movements for a specific task (such as blowing, kissing, or lip smacking). Option C Focus your lecture on how to assess range of motion, strength and speed during spontaneous speech. Option D Describe how to test strength by pushing the tongue against a tongue depressor; having the child resist movement of the lips with a tongue depressor; and having the child resist your attempts to push his jaw to a closed position. 7.Your lecture on the structural-functional exam went so well the University has asked you back to give a lecture on how to do a motor speech examination. How do you describe the goal or purpose of the motor speech examination to these first year graduate students? Option A You show how methods of measuring speech rate are most important to the goal of determining motor speech skill Option B You explain that the motor speech examination is designed to facilitate the identification of both the presence as well as the severity of dysarthria. Option C You emphasize the importance of examining the child’s ability to repeat a variety of utterances that vary in length and linguistic complexity to facilitate differential diagnosis. Option D You are careful to point out that the purpose of the motor speech examination is to determine the pattern of sound substitutions. 8.Twin children have been referred to you. They are 5 years, 6-months-old, with normal receptive language, but significant speech problems. They both achieve a standard score of 40 on the Goldman Fristoe Test of Articulation. Does their identical score on the articulation test mean that they have the same level of severity and therefore similar prognosis? Option A Yes. They have the same level of prognosis. Option B No, they have different levels of severity but the same prognosis. Option C Yes, they have the same level of severity. Option D No, it is possible that they have different levels of severity and a different prognosis. 9.A 4:10 year old child is referred to you with the question of whether he has a motor speech disorder. His birth history was normal and there is no history of serious illness, injury or hearing loss. His developmental milestones were all within normal limits with the exception of babbling which was minimal. He was seen by a pediatric neurologist who noted “generalized low tone, but normal strength”. All other findings were normal. He has only 6 word approximations, with very little vowel differentiation, including “ba” for bye; “da” for dad; “ma” for mom; “u” for up; “mu” for more; and “du” for down. Plosing is good for /b/ and /d/. He has no history of dysphagia. Structural functional examination was normal, but he exhibited a moderate non-verbal oral apraxia. He is social, exhibits joint attention and frequently points and gestures to request or respond. He laughs easily and appropriately, with good respiratory support. Phonation is normal. His receptive language has been tested and is in the average range. What are your initial hypotheses given this case? Option A There is evidence for autism since he has so little speech Option B There is evidence for a cognitive impairment Option C There is evidence for velar-pharyngeal deficits as well as a speech sound disorder. Option D There is evidence for a speech sound disorder, but no evidence for autism or cognitive impairment 10.The child described in the previous question demonstrated very poor performance on the motor speech examination. He was able to imitate some consonant-vowel, vowel-consonant, and reduplicated syllables, but only with significant cueing. He was not successful at any other level of the examination. His responses showed difficulty achieving initial articulatory configurations; vowel distortions, inconsistency over repeated trials, equal stress and segmentation on bisyllables and numerous sound omissions. Does the motor speech examination as well as the description above provide evidence for dysarthria? Option A A physician would have to confirm the diagnosis of dysarthria Option B One cannot tell at this point if there is evidence for dysarthria Option C No, there is no evidence for dysarthria. Option D Yes. There is evidence for Dysarthria 11.The description of the child’s responses on the motor speech examination (in the last two questions) indicates he was at least mildly facilitated by cueing. What does this mean? Option A If the clinician cued him, he could always produce the utterance adequately Option B It means that the child has an excellent prognosis for rapid progress through therapy. Option C It means the clinician utilized dynamic cueing. Option D It means if the clinician gave him a semantic cue, he did better. 12.Interpretation of the assessment of this child requires looking at performance across tasks and tests, as well as taking the history into account. Given the descriptions above, what would be the best diagnostic statement? Option A This child is exhibiting childhood apraxia of speech and phonologic impairment. Option B The clinician should not make a diagnosis of any kind Option C This child is exhibiting a severe phonologic impairment Option D The child has dysarthria

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