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Audiology Review: Preparing for the Praxis and Comprehensive Examinations
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Practice Questions
Use the following case to answer Questions 1–3.
Your patient is a 3-year-old female. Her parents report that the child speaks but does not say
as many words as her friends in kindergarten. They also report that her vocabulary is likely
around 100 words. During your evaluation, she produces the following statement about her
dog: “That Mommy da.”
1. Which type of error is the omission of ’s?
a.
Pragmatics
Phonology
b.
Morphology
c.
d.
Semantic
Explanation: The omission of ’s is an error in morphology. The ’s is a bound morpheme that adds
meaning to the word. Therefore, c is the correct answer.
2. The likely age of elimination for the phonological process of final consonant deletion (i.e., “da”
for “dog?”) is ____.
a. 2 years
b. 3 years
c. 5 years
d. 8 years
Explanation: Omitting /g/ in “dog” is final consonant deletion. The phonological process of final
consonant deletion is likely eliminated by 3 years of age. Therefore, b is the correct answer.
3. How many words should a 3-year-old have in their vocabulary?
a. 50 words
500 words
b.
c.
1,000 words
d. Over 2,000 words
Explanation: At 36 months or 3 years, a child should have approximately 1,000 words in their
vocabulary. This child is delayed in vocabulary development if her vocabulary consists of a total of 100
words. Therefore, c is the correct answer.

CHAPTER 4 Communication Across the Lifespan: Typical vs. Disordered
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Use the following case to answer Questions 4 and 5.
Your patient is a 70-year-old adult male. Recently, your patient suffered a stroke. After introducing yourself, you start the appointment by asking a few simple questions. You quickly notice that
your patient is speaking with ease, but using utterances that ar
answer the questions you are asking.
e not words. His answers do not
You: How are you today?
165
Patient:
You:
Patient:
We have stived here for a bet and talked to them over here.
Can you tell me why you are here?
We went over there to the hands. I talk of thets and more.
4. What type of aphasia does your patient demonstrate?
a.
Broca’s aphasia
Conduction aphasia
b.
c. Wernicke’s aphasia
d. Global aphasia
Explanation: This patient has Wernicke’s aphasia, which is characterized by fluent speech, jargon or
new words that do not have meaning, and poor auditory comprehension. Therefore, c is the correct
answer.
5. Aphasia is an acquired language disorder. This patient is having difficulty understanding
language and producing language that matches his intended message. This patient continues to
be just as intelligent as before his stroke. Knowing this, how might you adjust your evaluation?
a.
Use pictures, gestures, or video without language to facilitate comprehension
Repeat instructions several times, until he understands
b.
c. Cancel the evaluation. Language comprehension is required for many tasks.
d. Write all instructions for him to read.
Explanation: Use of pictures, gestures, or videos would not require language for comprehension. Any adjustment that did not include language may facilitate understanding for
completion of your evaluation. Repeating instructions may not be helpful, since he is having difficulty comprehending language. Although writing may be helpful, writing involves language.
Individuals with Wernicke’s aphasia may have difficulty reading written language. Therefore, a is the
correct answer.
6. Which of the following is true when considering standardized language and speech assessment
measures for children with hearing loss?
a. Standardized tests should never be used with children with hearing loss.
b. Standardized tests should rarely be used with children with hearing loss.
c. Standardized tests may be used with no restrictions for children with hearing loss.
d. Standardized tests may be used but results must be reviewed with caution for children with
hearing loss.

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Explanation: Standardized assessment measures for language and speech may be utilized for children
with hearing loss. However, the clinician must review the measure and apply any assessment results
with caution. Therefore, d is the answer.
7. Joyce no longer attends a weekly board game night with her friends because she is having
difficulty following along with the conversation due to her hearing loss. What is Joyce not
attending the game night an example of?
Participation restriction
a.
b.
Activity limitation
Bluffing
c.
d.
Anticipatory strategy
Explanation: A participation restriction is how hearing loss affects life participation in a broader
sense. Choosing not to attend a weekly game night because of deficits related to hearing loss would be
a participation restriction. Therefore, a is the correct answer.
8. James demonstrated difficulty with friends in part because of his difficulty with skills related to
theory of mind (ToM). Which of the following might have contributed to his difficulty with
ToM skills?
a. Difficulty using functor words when communicating
b. Difficulty using appropriate word order when creating sentences
c. Lack of an age-appropriate language base to mediate ToM skills
d. Lack of phonological awareness skills
Explanation: One reason ToM skills can be difficult for children with hearing loss is due to deficits
in expressive and receptive language. Without an adequate language foundation, it can be difficult for
children with hearing loss to utilize metalinguistic and metacognitive skills to process a concept like
ToM. Therefore, c is the correct answer.
9. An audiology patient nods in agreement during an audiological evaluation but does not
understand what was said. What is this an example of?
a. Acknowledgment gesture
b.
Bluffing
Anticipatory strategy
c.
d. Message tailoring strategy
Explanation: Bluffing is a maladaptive strategy where the person with hearing loss does not understand what was said by a conversational partner but nods or smiles in agreement. This contrasts with
and hinders the use of supportive strategies that a person with hearing loss might utilize during a
conversation. Therefore, b is the correct answer.

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10. A preschool child demonstrated a conditioned play response to a pure tone presented in the
sound booth. What level of auditory skill development was demonstrated?
a. Identification
b.
Comprehension
Discrimination
c.
d.
Detection
Explanation: Conditioned play audiometry involves game or play-like activities (e.g., dropping a
block into a bucket or placing a ring on a ring stacker) to elicit a response from a child to determine if
they detect a sound. A conditioned play response would only indicate the detection of a sound without
higher-level auditory skills required. Therefore, d is the correct answer.

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Appendix 4–A
Overview of Language Development Across a Lifespan
AGE RANGE RECEPTIVE LANGUAGE EXPRESSIVE LANGUAGE
Birth to
3months
4–6 months •
7 months–
1 year
• Infants startle to loud noises
• Listens and/or turns to voices
• Beginning to distinguish speech sounds
• Eye contact (Kaderavek, 2011)
Infants look toward the direction of
sounds
Respond to noises from toys
•
• Attends and respond to sounds, speech,
music, and other noises
•
Turns and looks in the direction of
sounds
Looks when someone points
•
• Responds to name
• Understands words for common items
and names (e.g., mama, cup, dog)
Starts to respond to simple words and
•
phrases (e.g., “no,” “want more?”)
•
Interacts during games
Listens to music or stories for short
•
periods of time
•
Joint visual attention between 10 and 12
months (Kaderavek, 2011)
Understands common words and names
•
Cooing sounds
•
• Specific cries based on different needs
• Smiles
•
Cooing and babbling when alone or with
others
Speech-like babbling sounds, such as /
•
ma/ or /pa/
Laughs
•
• Produces sounds when happy or upset
• Linking sounds together, such as /
mamama/ or /dadada/
Uses sounds to gain and maintain
•
attention of others
•
Points or uses gestures to communicate,
such as nodding for yes or pointing to
objects
• Imitates speech sounds
Begins producing a few words, but may
•
not be intelligible
1–2 years •
Responds to some simple verbal
commands (one-step commands)
• Responds to simple questions, such as
“Where is the ball?”
• Points to pictures in books or a few body
parts when named
• Uses new words
• Increasing number of words that can be
produced
Starts to name pictures
•
• Asks simple questions, such as “Where’s
doggy?”
• Begins to put two words together, such as
“no eat” or “more cookie”

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AGE RANGE RECEPTIVE LANGUAGE EXPRESSIVE LANGUAGE
169
2–3 years • Understands opposites, such as stop and
go
Follows two-step commands, such as
•
“Get the doll and put her in the bed.”
•
Comprehension exceeds expression
• Listens to stories for longer periods of
time
•
Comprehends simple humor
3–4 years •
Understands words for some colors
• Understands words for some shapes
• Understands words for family members
4–5 years •
Understands words for order, such as first,
last, and next
• Understands words for time, such as
today and tomorrow
Responds to longer commands, such as
•
simple three-part commands
•
Able to follow directions in the classroom
• Understands the majority of information
at home and in school
Provides labels for most objects
•
• Refers to things not in immediate area or
out of sight
•
Uses prepositions (e.g., “in,” “on,” “over”)
• Puts two to three words together
• Uses statements and questions
Responds to simple questions: who, what,
•
where
•
Produces rhyming words
• Uses pronouns
Begins using some plurals
•
• Asks simple “when” and “how” questions
• Puts more words together for utterances
(i.e., four words)
Talks about events in the day
•
• Able to use four sentences at a time
• Able to name letters and numbers
• Able to use sentences with more than one
action, such as “I play with her, and we
jump.”
• Able to tell a story
• Participates in conversation
Changes the way of talking for different
•
situations or with different people (e.g.,
talking quieter inside and louder outside)
School-age • Reading skills improve
Early and
middle
adulthood
Vocabulary of 25,000–30,000
•
• Understands 60,000 words by sixth grade
and 80,000 words by the end of high
school
• Comprehension becomes adult-like
•
Understands and uses slang
• Written language is more complex than
spoken language
• Content is broad and expanding
• Comprehension continues to increase • Content includes a full range of topics
• Vocabulary may be reflective of education
and occupation
• Written language continues to improve
continues

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APPENDIX 4–A. continued
AGE RANGE RECEPTIVE LANGUAGE EXPRESSIVE LANGUAGE
Advanced
age
• Comprehension may decrease with
hearing loss
Typically remains preserved
•
•
Naming and word-finding decrease
• Possible changes in comprehension
possibly associated with changes in
cognitive processing and hearing
Sources: Information obtained and adapted from ASHA (n.d.-a), DeDe and Flax (2016), Kaderavek (2011), Owens and Farinella
(2019), Wingfield and Grossman (2006).

Section III
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Assessment and
Differential Diagnosis
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