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. 161–172)

1. Dysarthria of spinal cord injury in someone who can breathe on their own is often characterized by which of the following speech features?

   • Loudness that increases over the course of the breath group

   • Breathy voice quality

   • Abnormally long breath groups and short pauses

   • Low and fading loudness and short breath groups

   • Vocal tremor

2. In individuals with spinal cord injury, the need for mechanical ventilation is usually related to weakness of the

   • abdominal muscles

   • diaphragm

   • internal intercostals

   • accessory muscles

   • external intercostals

3. Relatively intact diaphragm function with severely weakened abdominal and rib cage muscles may lead to any of the following, except

   • paradoxical breathing pattern

   • rib cage collapse with inspiratory efforts

   • orthopnea

   • larger vital capacity in supine position

   • excessive abdominal expansion during inspiratory efforts

4. What two ventilator adjustments may improve speech in someone who uses invasive ventilation (i.e., ventilation delivered via tracheostomy)?

   • Increased inspiratory time and increased positive end-expiratory pressure (PEEP)

   • Decreased tidal volume and decreased PEEP

   • Decreased inspiratory time and increased inspiratory pressure

   • Increased inspiratory time and decreased PEEP

   • Increased inspiratory flow and decreased PEEP

5. Breath stacking can be accomplished in any of the following ways, except

   • glossopharyngeal breathing

   • lung volume recruitment

   • successive sips of air via mouthpiece noninvasive positive pressure ventilation

   • successive inspirations with a resuscitation bag

   • successive inspirations with an open tracheostomy tube

   Article Two (pp. 173–183)

6. Oromandibular dystonia (OMD) is variable in presentation so it is classified based on location of the dystonic activity. Which of the following describes how OMD can be classified based on location?

   • Jaw opening dystonia

   • Jaw closing dystonia

   • Labial dystonia

   • Lingual dystonia

   • All of the above

7. The most contemporary and welltolerated treatment for OMD is

   • benzodiazepine drugs

   • bite block dental appliances

   • neurosurgery

   • botulinum toxin injections

   • none of the above

8. A tool that assesses communicative effectiveness is

   • The Glasgow Benefit Inventory

   • The Communicative Effectiveness Survey

   • American Speech-Language-Hearing Association's Quality of Communication Life scale

   • The Oromandibular Quality of Life Scale–25 (OMDQ-25)

   • The Voice Handicap Index

9. What are benefits to assessing communicative participation and quality of life in OMD?

   • It can provide comprehensive and holistic care for our clients with OMD.

   • It can help us to understand our client's perception of their communication disorder.

   • It can inform meaningful clinical outcomes.

   • It can help provide targeted support and educational strategies for our clients with OMD

   • All of the above are true.

10. Which of the following is a patientreported outcome measure that specifically assesses communicative participation?

    • Speech Intelligibility Test

    • Oromandibular Dystonia Questionnaire-25 (OMDQ-25)

    • Communicative Participation Item Bank

    • Glasgow Benefit Inventory

    • None of the above

    Article Three (pp. 184–190)

11. What is communicative participation?

    • The ability to be understood in a noisy environment

    • Communicating with someone over the phone

    • How satisfied one is about their communication

    • Taking part in life situations in which knowledge, information, ideas, or feelings are exchanged

12. Which of the following is not a reason why tools designed to assess communicative participation in adult populations should not be used in pediatric populations?

    • Children participate in different life situations than adults.

    • Children with developmental speech disorders did not suffer a “loss” of “typical” function.

    • Children are not reliable selfreporters of their own disability.

    • Cognitive-linguistic development is not as advanced in children as in adults.

13. At what age can children begin to provide reliable and valid self-reports of their disability?

    • 2 years old

    • 5 years old

    • 10 years old

    • 15 years old

14. How many patient-reported outcome tools designed to assess communicative participation in children are available for use by speech-language pathologists?

    • None

    • 5

    • 10

    • 30

15. During the development of a pediatric patient-reported outcome tool, it is important to ensure the tool

    • contains age-appropriate language

    • is reliable and valid across many different age groups

    • contains a parent proxy-report in the case that a child is too young or too cognitively impaired to provide a valid self-report

    • all of the above

    Article Four (pp. 191–199)

16. Collectively analyzing treatment options for people with dysarthria resulting from stroke, Parkinson's disease, or cerebral palsy is problematic because

    • randomized control trials do not have enough participants

    • treatment options are too limited

    • it is difficult to identify speakers with these conditions

    • the presentation of dysarthria within these groups can be highly heterogenous

17. Why should multivariate study designs be used to model speakers' treatment outcomes?

    • They enable researchers to measure participants' outcomes more accurately.

    • They enable researchers to examine the effects of individual's baseline speech features and contextual factors.

    • They lower the rate of negative outcomes following treatment.

    • They increase participants' engagement in speech therapy.

18. The identification of variables associated with poor treatment outcomes helps clinicians

    • justify the extension of a treatment program

    • apply the treatment program to a wider population of people with dysarthria

    • advocate for alternative treatment approaches

    • replicate single-case studies

19. Which baseline assessment features accounted for significant variations in intelligibility gains when speakers with hypokinetic dysarthria were cued to speak louder?

    • Speech rate and variation

    • Vowel centralization and dysarthria severity

    • Jitter and shimmer

    • Vital capacity and subglottal pressure

20. Automated acoustic analyses may be advantageous in the assessment of dysarthria because

    • they can be completed rapidly and are easy to accurately replicate across studies

    • their results are readily interpretable

    • all feature sets are closely linked to dysarthria severity

    • they provide data that are easier to analyze statistically

    Article Five (pp. 200–209)

21. As people age, which of the following changes to speech breathing occur?

    • Lung volume initiation decreases and lung volume termination increases.

    • Lung volume initiation increases and lung volume termination decreases.

    • Lung volume initiation and termination decrease.

    • Lung volume initiation and excursion increase.

    • Lung volume termination and excursion decrease.

22. As Parkinson's disease progresses, which of the following changes to speech breathing occur?

    • Lung volume initiation decreases and lung volume termination increases.

    • Lung volume initiation increases and lung volume termination decreases.

    • Lung volume initiation and termination decrease.

    • Lung volume initiation and excursion increase.

    • Lung volume termination and excursion decrease.

23. As Parkinson's disease progresses, which of the following changes occur to speech production?

    • Speech rate and utterance length decrease.

    • Speech severity and speech rate increase.

    • Speech severity and utterance length increase.

    • Speech rate and utterance length increase.

    • Speech severity increases and speech rate decreases.

24. As Parkinson's disease progresses,

    • speech breathing becomes more effortful

    • speech breathing becomes more efficient

    • speech breathing becomes more like that of young adults

    • speech breathing becomes more like that of age- and sex-matched older adults

    • speech breathing does not change

25. As the typical older adults age, which of the following changes occur to speech production?

    • Speech rate and utterance length decrease.

    • Speech severity and speech rate increase.

    • Speech severity and utterance length increase.

    • Speech rate and utterance length increase.

    • None of the above is true.

    Article Six (pp. 210–219)

26. Speech treatment for people with Parkinson's disease should

    • focus exclusively on improving speech loudness

    • focus exclusively on improving oral articulation

    • consider the many issues that might affect communication

    • occur late in the course of the condition when dysarthria is severe

27. Information about patient preferences

    • is a common topic for research in dysarthria

    • is important for setting treatment goals

    • can only be obtained from family members

    • is typically not considered in managing degenerative conditions

28. Dysarthria in Parkinson's disease

    • is the only consequence of the condition

    • can only be treatment by exercises to increase loudness

    • is not responsive to any type of treatment

    • may be influenced by many factors including cognition, medication cycles and other psychosocial variables

29. Self-management strategies

    • have been extensively studied in dysarthria

    • are not appropriate for the management of chronic conditions

    • are consistent with patient-centered practice

    • can only be used when drug intervention is involved

30. People interviewed about speech treatment

    • wished to learn strategies for managing communication situations

    • had the high expectation that their speech would be normal after treatment

    • indicated that regular extensive practice is easy to make a part of their regular schedule

    • found that the speech exercises were the most enjoyable part of therapy

    Article Seven (pp. 220–228)

31. Speech recognition technology has included discrete utterance as well as which of the following recognition algorithms?

    • Continuous speech

    • Fluent speech

    • Word by word

    • Phoneme level

32. The highest levels of speech recognition accuracy have been reported by individuals with which level of dysarthria?

    • Severe

    • Profound

    • Spastic

    • Mild

33. The highest levels of speech recognition accuracy for individuals with dysarthria have been reported for

    • multiple paragraphs of dictated text

    • multisyllabic words

    • small vocabulary sets and assistive technology applications (e.g., environmental control)

    • low predictability phrases

34. Most commercially available speech recognition technology has been primarily developed to support

    • speech practice

    • writing

    • environmental control

    • online shopping

35. If speech recognition technology were to become a clinical speech practice tool, which of the following changes were recommended in this article?

    • An easy way for clinicians to identify and change speech practice targets

    • Different kinds of feedback need to be incorporated (e.g., immediate versus delayed)

    • May need to include smaller subsets of recognition vocabularies

    • All of the above

    Article Eight (pp. 229–238)

36. Most programs for training medical students in patient-provider communication assume that patients have which of the following communication abilities?

    • Poor

    • Typical

    • Excellent

    • Nonexistent

    • Multilingual

37. What is the acronym used to represent a set of general communication strategies to consider using when interacting with patients with communication disorders?

    • SCOPE

    • STRETCH

    • FRAME

    • SEGUE

    • SPEAK

38. The portion of the training that students commented on the most and that seemed to be the most effective for their learning was the

    • online content describing dysarthria and other communication disorders

    • videos of individuals with dysarthria and other communication disorders

    • didactic content summarizing FRAME communication strategies to use

    • hands-on interactions with standardized patients

    • none of the above

39. Which of the following was not a targeted characteristic of hypokinetic dysarthria from Parkinson's disease portrayed by the professional standardized patients during their interactions with student trainees?

    • Imprecise (or slurred) articulation

    • Reduced speech loudness

    • Reduced intonation (i.e., monopitch) and loudness (i.e., monoloudness)

    • A normal speaking rate

    • A flat affect

40. Which of the following was not a “lesson learned” from the student trainees who completed this communication skills training program?

    • These communication skills are not being taught elsewhere in the students' curriculum.

    • Active practice implementing these communication skills is essential.

    • The resources required to develop and implement this type of communication skills training are “worth it.”

    • Student trainees feel they need more hands-on practice time for these communication strategies.

    • Student trainees feel like they are adequately prepared to communicate with patients with dysarthria and other communication disorders without this training.

    Article Nine (pp. 239–250)

41. A patient with cerebral palsy would be considered what type of communication vulnerable condition?

    • Pre-existing

    • Sudden onset

    • Intervention related

    • Temporary

    • Intervention caused

42. A person who provides daily communication support for a communication vulnerable patient would be a

    • communication coordinator

    • communication facilitator

    • legal intermediary

    • language interpreter

    • medical interpreter

43. A medical order the transfers care to another medical professional is a

    • individual order

    • care map

    • specific order

    • order set

    • legal order

44. A medical order that is initiated prior to admission for a medical condition is a(n)

    • individual order

    • care map

    • specific order

    • order set

    • legal order

45. A set of medical orders associated with a medical condition in a specific medical situation, such as inpatient rehabilitation, is known as a(n)

    • general order

    • individual map

    • specific order

    • order set

    • legal order