Praxis – Craniofacial – Flashcards

During a comprehensive speech evaluation, a speech-language pathologist (SLP) asks the child being evaluated to prolong the vowel /i/. The SLP asks the child to repeat the same vowel, but while pinching his/her nose closed. Upon completing this action, the SLP notices a change in the sound of the vowel. What type of resonance does this child MOST LIKELY demonstrate? A. Hypernasality B. Hyponasality C. Cul de sac resonance D. Mixed resonance

A child is referred to a speech-language pathologist (SLP) by an otolaryngologist (ENT) with a presenting problem of "distorted speech". Following a comprehensive evaluation, the SLP determined that the child is experiencing significant nasal emission during speech. Based on this information, which of the following problems would this child NOT be experiencing? A. Short utterance length B. Compensatory errors C. Hypernasality D. Weak consonants

A speech-language pathologist (SLP) has been assigned to provide therapy to a child with a documented history of velopharyngeal insufficiency (VPI). Which activity would be the most appropriate method of therapy for the SLP to utilize this particular client? A. blowing exercises B. oral-motor exercises C. articulation therapy D. increasing oral activity

A young child with developmental dysarthria exhibits hypernasality and nasal emissions on pressure consonants. Examination of the hard palate failed to note any structural deviations while range of motion for elevation of the soft palate appeared limited. Occlusion of the nose via a nose clip normalized breath group length and improved clarity of speech sound production. What step should the SLP take next in order to proceed appropriately? A. The speaker should be immediately fitted with a palatal lift. B. Complete a thorough evaluation of the velopharyngeal system prior to initiating treatment. C. Treatment should target the respiratory system in order to improve breath group length. D. Refer the child for reconstruction of the velopharyngeal system.

A speech-language pathologist (SLP) has been working with a patient to improve the hyper nasality of their speech. The child has been diagnosed with a cleft palate, but also demonstrates a Pierre Robin sequence, mid-face hypoplasia and a mild sensorineural hearing loss. Given these specific characteristics, this child MOST LIKELY demonstrates which disorder? A. Fetal alcohol syndrome B. Trisomy 13 C. Stickler syndrome D. Orofaciodigital syndrome type 1

A speech and language researcher is interested in compiling a data bank regarding objective measures of the acoustic characteristics of cleft palate speech. Which of the following instrumental procedures would be most helpful to this researcher? A. Nasopharyngoscopy B. Aerodynamic instrumentation C. Videofluoroscopy D. Nasometry

A client arrives at the speech-pathology clinic at an acute care hospital with complaints of "a change in voice." After comprehensive endoscopic evaluation, the speech-language pathologist (SLP) notes that the deficit is most likely not one of resonance due to problems of velopharyngeal closure, as this client exhibits "the most common pattern of velopharyngeal closure." Which of the following BEST describes this client's pattern of closure? A. Circular pattern with approximately equal activity of the velum, lateral pharyngeal walls and posterior pharyngeal wall B. Coronal pattern with the velum contacting the pharyngeal wall C. Sagittal pattern with medial pharyngeal wall motion as the primary contributor to closure D. Circular patten with a Passavant's ridge

A child has been recently born with a complete cleft of the secondary palate. Given this diagnosis, which structure would most likely NOT be affected? A. Hard palate B. Velum C. Alveolar ridge D. Uvula

A 6-year-old child was referred to a speech language pathologist (SLP) by an otolaryngologist (ENT) physician, in order to receive speech therapy. According to the client's mother, the child has normal speech until 2 years ago, when he underwent adenoidectomy. Following this surgery, the child demonstrated severe hyper nasality, which was slightly improved over the past year. The SLP performs a full evaluation, which reveals normal articulation and significant hyper nasality. What is the FIRST treatment option that should be instituted for this child? A. Speech and voice therapy for better sound control and airflow B. Exercises to strengthen the velopharyngeal musculature C. Discuss the inappropriateness of speech therapy, at this time, for the child with the physician D. Auditory training to improve awareness of the hyper nasality

A speech-language pathologist (SLP) is scheduled to perform an evaluation on a child with a chief complaint of "nasality." After performing the evaluation, the SLP finds that the child demonstrates insufficient resonance of nasal consonants. What type of resonance does this child demonstrate? A. Hypernasality B. Hyponasality C. Oral cul de sac resonance D. Nasal cul de sac resonance

After receiving surgical correction of velopharyngeal insufficiency, a child is referred to a speech-language pathologist (SLP) to receive speech therapy. Which activity is appropriate for correction of compensatory errors following the child's surgical procedure? A. Articulation placement procedures B. Velopharyngeal exercises C. Blowing exercises D. Further surgical management

A neonate was diagnosed with cleft palate, micrognathia and airway obstruction. Given these characteristics, which of the following disorders is this infant MOST LIKLEY experiencing? A. Pierre Robin sequence B. Velocardiofacial syndrome C. Down syndrome D. Pfeiffer syndrom

Following a complete otolaryngology (ENT) and speech-language pathology (SLP) evaluation after complaints of hyper nasal speech, a child is diagnosed with a complete cleft of the primary palate. Which of the following structures would most likely NOT be affected by this type of cleft? A. Lip B. Hard palate C. Alveolar ridge D. Nasal sill

A child was referred to a speech-language pathologist (SLP) in order to receive speech therapy for problems associated with velopharyngeal insufficiency (VPI). In the referral notes, the SLP notices that this child demonstrates several common speech characteristics associated with VPI. Which of this child's speech characteristics would be most responsive to speech therapy? A. Hypernasality B. Compensatory productions C. Obligatory errors D. Nasal emission

A speech-language pathologist (SLP) in an outpatient clinic had a child referred to them by an otolaryngologist (ENT). In the client's notes, the physician states that the client demonstrates problems that are not able to be corrected medically or surgically and that speech therapy is indicated for this child. Given this information, which deficit is this child MOST LIKELY demonstrating? A. Cul de sac resonance B. Nasal emission C. Pharyngeal fricative D. Hypernasality

A speech-language pathologist (SLP) in private practice has been working with a child for the past 6 months in order to correct the child's speech distortions. However, the child has made no progress over the course of treatment, and the SLP prepares a referral for otolaryngology (ENT) intervention. With which of the following distortions does this child MOST LIKELY present? A. Glottal stop B. Compensatory production C. Phoneme-specific nasality D. Obligatory distortion

A speech-language pathologist (SLP) in private practice is receiving a new client in the clinic for treatment of a speech sound disorder. Upon reading the child's intake forms, the SLP notes that the child has previously been diagnosed with pronounced micrognathia, glossoptosis and hearing loss. Given these specific characteristics, this child MOST LIKELY demonstrates which disorder? A. Treacher Collins syndrome B. Beckwith-Wiedemann syndrome C. Van der Woude syndrome D. Optiz G syndrome

A child is referred to an otolaryngology (ENT) and speech-language pathologist (SLP) clinic at an acute care hospital after experiencing multiple episodes of nasal regurgitation in addition to significantly hyper nasal speech. Upon full evaluation, it is found that the child has difficulty with elevation and retraction of the velum. Given these problems, this child is MOST LIKELY experiencing deficits in which of the following muscles? A. Tensor veli palatini B. Musculus uvulae C. Palatoglossus D. Levator veli palatini

You have been asked to given an in-service to a group of students who wish to eventually specialize in service delivery to children with cleft palates and their families. The students want to know detailed information about in utero development of the hard and soft palate (among other things). You can accurately tell them that in utero, the hard palate fuses between the developmental ages of: A. 1 and 2 weeks B. 4 and 6 weeks C. 8 and 9 weeks D. 10 and 12 weeks E. 12 and 16 weeks

A clinician in a private practice is approached by the parents of Tommy D., a 5-year-old boy. The parents want to place tommy in Kindergarten in the fall but say, "We know there's something wrong with him--we're just not sure what." According to Tommy's parents, he is a "sweet, lovable boy who will go to anybody. He likes to sing a lot, too." Because the parents live in a rural area, health care access has been limited. After seeing Tommy for the first time, the clinician refers his parents to a neurologist because she suspects that Tommy has a syndrome. He is small for his age and has an elfin-like appearance characterized by a small chin, turned-up nose, puffiness around the eyes, a long upper lip, and a wide mouth. His teeth are small and widely spaced. The clinician suspects that Tommy has: A. Williams syndrome B. Apert syndrome C. Moebius syndrome D. Turner syndrome E. Hurler syndrome

A clinician in a private practice is approached by the parents of Tommy D., a 5-year-old boy. The parents want to place tommy in Kindergarten in the fall but say, "We know there's something wrong with him--we're just not sure what." According to Tommy's parents, he is a "sweet, lovable boy who will go to anybody. He likes to sing a lot, too." Because the parents live in a rural area, health care access has been limited. After seeing Tommy for the first time, the clinician refers his parents to a neurologist because she suspects that Tommy has a syndrome. He is small for his age and has an elfin-like appearance characterized by a small chin, turned-up nose, puffiness around the eyes, a long upper lip, and a wide mouth. His teeth are small and widely spaced. This syndrome is caused by a rare genetic disorder that affects an estimated 1 out of every 20,000 babies. It is caused by: A. a missing part of chromosome 22, known as 22q11 B. an expanded number of cytosine-guanine-guanine (CGG) nucleic acid repeats on a specific gene on one of the distal ends of the X-chromosome C. a spontaneous autosomal dominant mutation, whose gene and locus is FGR2 at 10q25-26 D. autosomal dominant inheritance and deletion in the region of the long arm of chromosome 15 (15q11-15q13) E. the deletion of approximately 25 genes on one copy of chromosome 7q11.23.

A clinician in a private practice is approached by the parents of Tommy D., a 5-year-old boy. The parents want to place tommy in Kindergarten in the fall but say, "We know there's something wrong with him--we're just not sure what." According to Tommy's parents, he is a "sweet, lovable boy who will go to anybody. He likes to sing a lot, too." Because the parents live in a rural area, health care access has been limited. After seeing Tommy for the first time, the clinician refers his parents to a neurologist because she suspects that Tommy has a syndrome. He is small for his age and has an elfin-like appearance characterized by a small chin, turned-up nose, puffiness around the eyes, a long upper lip, and a wide mouth. His teeth are small and widely spaced. The clinician knows that she will probably end up seeing Tommy for intervention if his parents are able to bring him on a weekly basis. She will probably be working on which of the following goals? A. Pragmatics to increase Tommy's ability to interact with others B. Oral-motor coordination, because children with this syndrome usually have oral-motor coordination problems, which contribute to decreased intelligibility C. Overall expressive and receptive language, because children with this syndrome generally have IQs of 50-70 (although some have good language skills) D. Morphological skills, because although children with this syndrome usually have above-average IQs, they frequently delete bound morphemes from the beginnings and end of words E. Feeding, because children with this syndrome tend to have feeding problems

A condition in which the surface tissues of the soft or hard palate fuse but the underlying muscle or bone tissues do not is called: A. fusion disorder B. submucous or occult cleft palate C. class III palatal cleft D. submucosal cleft class IV E. occult palate class I

A clinician who is using a client-centered approach to counseling a client with a communication disorder will A. be very directive, making specific recommendations for behavioral changes B. help the client understand repressed conflicts between the id, ego, and superego C. help the client to overcome faulty thinking that is causing distress. D. respond with acceptance and empathetic listening to both the content and the feeling of what the client is saying E. give specific advice and look for measurable behavioral changes that occur as a result of the client implementing that advice

Speech-language pathologists working in medical settings frequently see patients who have been assessed with medical imaging techniques. A technique that uses emission-computed tomography to allow imaging of metabolic activity through measurements of radioactivity in the section of the body being viewed is called: A. fluoroscopy B. MRI C. a PET scan D. EEG E. a CT scan

The surgical method of cleft palate repair that involves raising two bipedicled flaps of mucoperiosteum, bringing them together, and attaching them to close the cleft is called the: A. von Langenbeck surgical method B. V-Y retroposition C. Veau-Wardill-Kilner method D. pharyngeal flap procedure E. pharyngoplasty

A child comes to a clinic with her mother for articulation therapy. The mother tells the clinician that her daughter has Hurler's syndrome. Hurler's syndrome is caused by: A. autosomal recessive deficiency of X-L iduronidase B. a spontaneous autosomal dominant mutation of FGR2 at 10q25-26 C. autosomal dominant inheritance and deletion in the region of the long arm of chromosome 15 D. an expanded number of cytosine-guanine-guanine (CGG) nucleic acid repeats on a specific gene on one of the distal ends of the Y-chromosome E. an extra whole number chromosome 21, resulting in 47, rather than the normal 46 chromosomes

In infants and children with cleft palates, eustachian tube dysfunction is probably mostly related to the lack of contraction of the A. levator veli palatini muscle B. veli palatini muscle C. tensor palatini muscle D. superior constrictor

A child from Apple City transfers to Middleton City, and his file indicates that he has been receiving speech-language services in Apple City. To the chagrin of the Middleton City clinician, some pages of the report from the SLP in Apple City are missing. However, on the first page, it is indicated that this child has Moebius syndrome. He also has a history of frequent hospitalizations. The Middleton City clinician can probably except to find that this child: A. has low muscle tone, a history of early feeding difficulties, initial failure to thrive, obesity after the first year, and underdeveloped genitals B. has underdeveloped facial bones, including mandibular hypoplasia, malaria hypoplasia, dental malocclusion, and downwardly slanted palpebral fissures C. has a small maxillary structure, sphenoethmoidal synchondroses, ocular hypertelorism, facial asymmetry including a tall forehead, and brachycephaly D. may have delayed language and an articulation disorder, as well as bilabial paresis and weak tongue control for lateralization, elevation, depression and protrusion; a mask like face; a history feeding problems in infancy; an unilateral or bilateral paralysis of the abductors of the eye

A clinician is a member of a cleft palate team that asks her to conduct an objective assessment of an 8-year-old child's velopharyngeal mechanism. The clinician decides to do nasopharyngoscopy, in which a nasopharynoscope is passed through the middle meatus and back to the area of velopharyngeal closure. This will enable the clinician to observe the child's: A. adenoid pads and anterior pharyngeal walls as the child prolongs /s/ B. posterior and lateral pharyngeal walls as the child prolongs /s/ C. nasal aspect of the velum and the adenoid pads as the child produces CVC words D. posterior and lateral pharyngeal walls, as well as the nasal aspect of the velum and the adenoid pad, as the child produces sentences

You are on a cleft palate and craniofacial anomalies team that evaluates children with cleft palates. When child has a resonance problem, the team decides whether the child will benefit from speech therapy alone or more intensive medical intervention (e.g., surgery) is needed. As past of the assessment process, cephalometric analysis is used. In cephalometric analysis, the Cephalometric Assessment of Velopharyngeal Structures computer program analyzes the ratio relationship between the length of the soft palate and the depth of the nasopharynx. Which one of the following statements best summarizes a key principle that guides treatment decisions? A. A ratio of less than 60 is usually found when the soft palate is too short and the nasopharynx is too shallow. B. A ratio of less than 60 is usually found when the nasopharynx is too deep or the soft palate is too long. C. A ratio of 60-80 generally indicates adequate tissue for velopharyngeal closure for speech. D. If a ratio is higher than 80, this means that nasopharynx is too shallow or the velum is too long.

You are providing support for a man with Marfan syndrome; he has difficulties with respiration, and you are working on breathing techniques. He shares with you that he and his wife want to have a child, and they are concerned about their child possibly having Marfan syndrome. You refer him to a genetic counselor, who will share with him that Marfan syndrome is: A. an autosomal, dominant inherited disorder caused by mutations in the FBN1 gene B. an autosomal recessive disorder caused by mutations in the FBN1 gene. C. not genetically transferred to offspring, so the parents do not need to be concerned. D. a partial deletion syndrome caused by mutations in the FBN2 gene.

As part of your job in a public school district, you serve several preschools. You get an urgent call from a parent at one of the schools. She states that her daughter Michelle (age 4), who previously had typical language skills, has suddenly "lost her words" and is having seizures. She shares that Michelle "is so much more hyper now, and we don't know what's wrong." The mom shares that they have an appointment with Michelle's pediatrician to find out more about what is happening. You support this decision, especially because you suspect that Michelle has: A. Williams syndrome B. Landau-Kleffner syndrome C. Pierre-Robin syndrom D. Angelman syndrome

In your private practice, a father brings his 5-year-old son, Jordan to see you. The Kindergarten teacher has noticed that Jordan "talks kind of funny" and sometimes other children make fun of him. Justin was born with a cleft palate and has had repair surgery, and he has a history of conductive hearing loss secondary to otitis media with effusion. During your evaluation of Jordan's speech, you note that he is especially having difficulty producing affricates, fricatives, and plosives. This is probably because he is having continued difficulty with A. vocal nodules B. hypertrophied adenoids C. mandibular hypoplasia D. velopharyngeal closure