Self-Assessment Questions

This section provides a review. Mark each statement on the Answer Sheet according to the factual materials contained in this issue and the opinions of the authors.

Article One (pp. 3–14)

1. Which of the following is best visualized on flexible endoscopic evaluation of swallowing?

   • Secretions

   • Hyolaryngeal excursion

   • True vocal folds

   • Surface mucosa

   • A, C, and D

2. Whiteout is due to

   • laryngeal elevation

   • base of tongue or velar/posterior pharyngeal wall contact

   • glottic closure

   • cricopharyngeal opening

3. Proper positioning of the endoscope to identify pharyngeal delay requires that the tip of the scope be

   • in the vallecular space with a view of the lingual surface of the epiglottis

   • superior to the epiglottis with a view of the base of tongue

   • in the pyriform sinus with a view of distal pharyngeal mucosa

   • in the nasopharyngeal port with a view of the superior surface of the velum

4. During flexible endoscopic evaluation of swallowing, you cannot reliably identify

   • delayed pharyngeal swallow

   • aspiration during the swallow

   • pharyngeal residue

   • tongue manipulation of the bolus

5. Common swallow patterns in stroke patients include

   • poor oral control resulting in unintentional passage of the bolus into the pharynx

   • reduced swallowing initiation resulting in a delay in the execution of the pharyngeal stage of swallowing

   • residue coating the posterior pharyngeal wall due to reduced pharyngeal contraction

   • residue from weakness, which could be bilateral or unilateral

   • A, B, and D

   Article Two (pp. 15–24)

6. Dysarthria types are typically associated with specific lesion locations. Which of the following does not represent a dysarthria type and corresponding site of disruption?

   • Spastic dysarthria resulting from bilateral upper motor neuron damage

   • Hyperkinetic dysarthria resulting from bilateral upper motor neuron damage

   • Ataxic dysarthria resulting from damage to the cerebellar circuit

   • Flaccid dysarthria resulting from damage to cranial nerves

7. Bedside evaluation of laryngeal integrity can be accomplished through

   • sustained phonation

   • laryngeal diadochokinesis

   • contrasting glottal cough and coup

   • A and B

   • all of the above

8. The presence of involuntary movements is most often associated with

   • basal ganglia involvement

   • unilateral upper motor neuron impairment

   • cranial and spinal nerve disruption

   • bilateral upper motor neuron involvement

9. When screening the respiratoryphonatory subsystem, a water glass manometer can be a quick and useful tool. With this method, respiratory adequacy for speech can be determined by the ability to sustain

   • 5 cm H₂O of pressure for 5 seconds

   • 1 cm H₂O of pressure for 15 seconds

   • 20 cm H₂O for 20 seconds

   • 1 cm H₂O for 5 seconds

10. Distinguishing characteristics of flaccid dysarthria include all of the following, except

    • hypernasality

    • audible inspiration

    • strained vocal quality

    • nasal emission

11. As a whole, oromotor exercises are best used

    • in the context of speech

    • with individuals with weakness from nonprogressive flaccid dysarthria

    • with systematic progression and overload

    • in all of the above situations

    Article Three (pp. 25–36)

12. Which one of the following characteristics is considered unique to apraxia of speech (AOS)?

    • Sound distortions

    • Phonemic substitution errors

    • Distorted substitution and/or distorted addition errors

    • Articulatory groping

    • Utterances reduced in length

13. What benefit does acoustic analysis provide for the evaluation of apraxic speech?

    • Acoustic measures are less biased when compared with perceptual evaluation.

    • Acoustic measures may play a role in prognosis and predicting response to treatment.

    • Acoustic measures are reliable because they require sophisticated equipment to obtain.

    • Both A and C are true.

    • Both A and B are true.

14. Which of the following brain areas was not discussed as being implicated in AOS?

    • Insula

    • Premotor cortex

    • Supramarginal gyrus

    • Broca area

    • Temporal pole

15. Which of the following statements is true?

    • AOS most frequently occurs in isolation.

    • Error variability has been shown unanimously to be a useful metric to diagnose AOS.

    • Individuals with aphasia (but without AOS) may present with infrequent distortion errors during speech production.

    • Infarct location is not an important factor in poststroke deficits.

    • AOS and aphasia result from the same level of speech production—at the level of phonological encoding.

16. In studies that have investigated the pairwise variability index coefficient for vowel duration, which of the following has been shown?

    • Individuals with AOS have reduced pairwise variability index (PVI) coefficients when compared with those without AOS.

    • PVI coefficients are better for the diagnosis of aphasia.

    • The process of obtaining PVI coefficients is too time-consuming to use in clinical practice.

    • PVI appears to be reliable for the differential diagnosis of progressive AOS, not stroke-induced AOS.

    • PVI coefficients are only useful for the diagnosis of dysarthria.

    Article Four (pp. 37–52)

17. A hybrid of clinical effectiveness and implementation science design tests which two outcomes simultaneously?

    • Efficiency of assessment administration and effectiveness of documentation

    • Feasibility of standardization and clinician satisfaction

    • Outcome of clinical intervention and effectiveness of implementation strategy

    • Standardization of assessment and ability to diagnose type of aphasia

18. Which of the following factors was considered during the four phases of implementation (length of administration, ability for the assessment to be administered in a variety of patient rooms, a minimal materials requirement, the encompassment of various domains of language, and diagnostic capacity)?

    • Initial considerations of the host setting

    • Creating a structure for implementation

    • Ongoing structure once implementation begins

    • Improving future applications

19. The Western Aphasia Battery—Revised was selected for which of the following reason(s)?

    • Efficient to administer

    • Generates a diagnosis

    • Generates quantitative measure of severity

    • All of the above

20. Patients with severe deficits in the most acute stages of aphasia were

    • always evaluated using the Western Aphasia Battery—Revised

    • screened to determine candidacy for participating in assessment

    • automatically judged ineligible to participate in assessment

    • not seen by the speech-language pathologist until their aphasia improved

21. Preliminary results have demonstrated that use of a standardized aphasia battery in the acute care setting results in

    • significant increase in documenting an aphasia diagnosis

    • qualitative improvements in report organization

    • subjective feedback that assessment administration is more efficient

    • all of the above

    Article Five (pp. 53–65)

22. Speech-language pathology (SLP) group treatment literature describes treatment that

    • dates back to the 1900s

    • is conducted primarily in an acute rehabilitation setting

    • reduces participants' initiation of communication

    • is efficacious but does not promote social closeness

    • demonstrates outcomes for functional communication, expressive language, and auditory comprehension that are similar to those for individual therapy

23. Which of the following does not describe the role of the SLP group leader?

    • Provides tools and materials to group members for adequate participation in the group session

    • Selects cognitively and linguistically complex treatment activities

    • Exerts control over the majority of communicative acts within the group session

    • Delivers appropriate methods of cuing

    • Incorporates group member interests into activity selection

24. SLP groups should be designed to include

    • participants with disorders of similar severity

    • only participants with the same type of disorder

    • participants with varied disorder severity

    • six to eight group members

    • C and D

25. Patients report benefits of SLP group therapy that include all of the following except

    • support from other people with aphasia

    • opportunities to give support to other people with aphasia

    • improvement in quality of friendships

    • increased confidence

    • feelings of self-worth, hope, and empowerment

26. SLP group treatment promotes generalization of newly learned strategies and behaviors across

    • settings

    • communication partners

    • communication functions

    • none of the above

    • all of the above

    Article Six (pp. 66–78)

27. Which technique measures the diffusion of water molecules in the brain??

    • Computed tomography

    • Diffusion-weighted imaging (DWI)

    • Perfusion-weighted imaging (PWI)

    • Task-based functional magnetic resonance imaging (fMRI)

    • Resting state fMRI

28. Which technique creates images of white matter tracts in the brain?

    • DWI

    • PWI

    • DTI

    • Task-based fMRI

    • Resting state fMRI

29. Suppose an individual has an acute stroke. Initially, the individual has very poor performance on a naming task, but over the next few days improves dramatically. Which finding might you expect to see when comparing imaging from these different time points?

    • Reduced abnormality on PWI

    • Increased abnormality on DWI

    • Reduced connectivity on resting state fMRI

    • Increased activation on a control task in task-based fMRI

30. Which technique uses blood oxygenation level dependent contrast imaging to produce information related to brain function?

    • Positron emission tomography (PET)

    • fMRI

    • Electroencephalography

    • magnetoencephalography

31. Which of the following statement is true?

    • fMRI is invasive and exposes the subject to radiation.

    • PET is invasive and exposes the subject to radiation.

    • fMRI has poor spatial resolution compared with PET.

    • PET has better temporal resolution compared with fMRI.

    Article Seven (pp. 79–86)

32. What are the advantages of studying aphasic individuals acutely after stroke, in an effort to identify brain areas that are critical for specific functions?

    • It is easier to test people in the hospital.

    • It enables one to study the effects of lesions before reorganization of structure-function relationships (brought about by recovery with or without rehabilitation).

    • People are less anxious acutely after stroke.

    • People have more time for evaluation right after stroke.

    • People are more likely to consent to research while they are in the hospital.

33. What areas of the brain, when damaged, lead to impaired word comprehension?

    • Left inferior frontal gyrus

    • Left angular gyrus

    • Left supramarginal gyrus

    • Left posterior superior temporal gyrus

    • Left premotor cortex

34. The results of this study indicate that one role of the left posterior superior temporal gyrus and the left retrolenticular white matter region is

    • to link spoken words to their meanings

    • to distinguish phonologically related words

    • to distinguish visually similar objects

    • to access orthographic representation

    • all of the above

35. An example of a semantic error in word comprehension is

    • calling a rabbit a mouse

    • calling a rabbit a habit

    • calling a rabbit a carrot

    • accepting the label rabbi for a pictured rabbit

    • accepting the label opossum for a pictured rabbit

36. An example of a phonological error in word comprehension is

    • calling a rabbit a mouse

    • calling a rabbit a habit

    • calling a rabbit a carrot

    • accepting the label rabbi for a pictured rabbit

    • accepting the label opossum for a pictured rabbit

    Article Eight (pp. 87–100)

37. Studies indicate that the role of the right hemisphere is

    • featural processing of faces expressing positive and social emotions

    • global or configural processing of faces expressing negative emotions

    • preferential processing of social emotions conveyed via facial expressions

    • similar to the role of the left hemisphere in recognition of emotional faces

38. The role of the amygdala is

    • specific to processing fearful faces

    • specific to processing faces conveying anger and joy

    • processing fearful faces as well as those conveying anger and joy

39. The insula has a role in processing facial expressions of

    • fear

    • anger

    • disgust

    • all of the above

40. One finding from this study was that

    • right hemisphere stroke patients performed significantly worse than controls in recognizing emotional faces

    • all patients with right hemisphere lesions were impaired in recognition of emotional faces

    • patients with amygdala or anterior insular damage were not impaired in recognition of happy faces

41. Deficits in recognition of facial expression caused by right hemisphere lesions

    • can result in social isolation

    • be associated with decreased marital satisfaction

    • can result in incorrect assessments of another's affective state and inappropriate responses

    • all of the above