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. 55–62)

1. Voice disorders in school-aged children can negatively impact reaching educational goals by

   • limiting classroom participation

   • reducing concentration during academic activities.

   • all of the above

   • none of the above.

2. Functional voice disorders that occur from phonotraumatic behavior can include

   • vocal nodules

   • asthma

   • cerebral palsy

   • laryngomalacia

3. The best treatment model for working with school-aged children with voice disorders

   • is classroom pullout

   • is consultative model

   • is collaborative model

   • should be determined on a case by case basis

   Article Two (pp. 63–70)

4. What percentage of school-aged children have voice problems sufficient to warrant treatment?

   • Less than 1%

   • 2 to 3%

   • 5 to 10%

   • 10 to 15%

   • 20%

5. In most cases, what is the most important diagnostic component of the evaluation of a child with dysphonia?

   • Perceptual voice assessment by the clinician

   • Acoustic and aerodynamic analysis of voice

   • Surrogate measures of voice-related quality of life

   • Flexible fiberoptic laryngoscopy in the clinic

   • Direct microlaryngoscopy under anesthesia

6. Which of the following is not considered a cause of dysphonia in children?

   • Laryngeal papillomatosis

   • Laryngomalacia

   • Intubation-related vocal fold scar

   • Ligation of patent ductus arteriosus

   • Gastroesophageal reflux

7. What potentially life-threatening cause of dysphonia can occur in children?

   • Laryngeal papillomatosis

   • Unilateral vocal fold paralysis

   • Intubation-related vocal fold scar

   • Sulcus vocalis

   • Gastroesophageal reflux

8. Vocal nodules are felt to resolve by adolescence in what percentage of cases?

   • 100%

   • 90%

   • 80%

   • 70%

   • 50%

   Article Three (pp. 71–79)

9. The trilaminate structure of the vocal fold lamina propria

   • is fully present at birth

   • becomes apparent by age 2 in most children

   • is not fully developed until after puberty

   • has not been described for humans

10. Long-term average spectra for children

    • tend to show greater intensity in higher partials for boys compared to girls

    • tend to show greater intensity in higher partials for girls compared to boys

    • show equal intensity in higher partials in boys and girls

    • are not possible to compute for children below the age of about 16 years

11. Background noise levels in preschools and schools have been measured between

    • 55 to 60 dBA

    • 60 to 68 dBA

    • 70 to 72 dBA

    • 72 to 80 dBA

    Article Four (pp. 80–93)

12. Approximately what percentage of school-aged children with voice problems receive voice therapy services in the schools in the United States?

    • 75%

    • 50%

    • 25%

    • 15%

    • 1%

13. What effect may loud voice have on a child's vocal folds?

    • High likelihood of phonotrauma (vocal fold injury)

    • Medium likelihood of phonotrauma

    • Minimal likelihood of phonotrauma

    • Depends on how the child is using the vocal folds to produce loud voice

    • Has not been discussed in the literature in relation to phonotrauma

14. What does the contemporary literature say about the best focus of attention to optimize motor learning?

    • Attention should be directed to the biomechanics of movement.

    • Attention should be directed to movement outcomes.

    • Attention should be directed to instrumented feedback as movement occurs.

    • Attention should be directed to emotional processes before and during movement.

15. Which manipulation may impair immediate performance during training but enhance generalization to other tasks in the same class later?

    • Frequent augmented feedback

    • Concurrent augmented feedback

    • Whole practice

    • Variable practice

    • Blocked practice

16. Which factors may negatively affect a child's participation in (compliance with) voice therapy?

    • Parental support

    • Minimizing complexity in the therapy program

    • Minimizing cosmetic side effects

    • Rapport with the clinician

    • All of the above

    Article Five (pp. 94–102)

17. During conflicts, language disorders in preschoolers may lead to all of the following except

    • victimization

    • psychotic episodes

    • aggression

    • poor play skills

    • voice problems

18. Children with language and learning disabilities are overrepresented in the juvenile justice system. Research reports the prevalence to be

    • 5%

    • 12%

    • 37%

    • 42%

    • 65%

19. Cohen's conflict resolution pyramid includes all of the following except

    • coaching

    • prevention

    • explicit teaching

    • individual behavioral support plans

    • adult resolution

20. Classroom-based presentation of Talk It Out does include

    • scripted dialogue

    • “Talk It Out” song

    • reinforcement

    • facilitated practice/coaching

    • all of the above

21. The implementation of daily Talk It Out experiences in the classroom does not require

    • teacher training

    • frequent implementation

    • direct services by a speech-language pathologist

    • a common language across classrooms and home

    • individualization of strategies

    Article Six (pp. 103–115)

22. The prevalence of voice problems in early school-age children is

    • 1%

    • 80 to 100%

    • 6 to 24%

    • 7%

    • none of the above

23. The most common symptom of voice disorders in children and the most common laryngeal pathology are

    • vocal tremor and neurogenic disorders

    • hoarseness and vocal nodules

    • hoarseness and vocal fold paralysis

    • yelling and vocal fold bowing

    • all of the above

24. Classroom-based instruction on the voice typically includes

    • education about how the voice is produced

    • information about the anatomy of the voice box, or larynx

    • identification of voicing behaviors that can damage laryngeal tissues

    • voicing strategies that can be used in place of yelling or other unhealthy voicing behaviors

    • all of the above

25. Which of the following behaviors was studied from pre- to post-voice education program in preschool-aged children in the current study?

    • The frequency of yells by participants in different school-related contexts

    • The intensity of the classroom.

    • The fundamental frequency of the participating children

    • The frequency of making car noises

    • The frequency of yells produced by the classroom teachers

26. Which of the following is not a true statement about the findings of this study?

    • All participants demonstrated significant reduction in the frequency of yelling on the playground.

    • Children in the high-frequency yelling group showed the greatest reduction in yelling frequency from pre- to postprogram.

    • All participants demonstrated significant reduction in the frequency of yelling during classroom free play.

    • Yelling was completely eliminated upon completion of the program in children identified before the program as low-frequency yellers.

    • Upon completion of the program, the children in the highfrequency yelling group reduced their average frequency of yelling to similar preprogram levels measured in the neutral and low-frequency yellers.

    Article Seven (pp. 116–128)

27. Which characteristic and/or symptom is not associated with nonspecific chronic cough (NSCC)?

    • Nonproductive cough

    • Predictable, repetitive rhythmic cough pattern

    • Cough that is absent when asleep

    • Cough that is nonresponsive to cough medications

    • Inspiratory stridor

28. Interdisciplinary teams are critical when treating children with NSCC and paradoxical vocal fold motion disorder (PVFMD). Who might be the best-suited professional to provide information on the child with NSCC?

    • Speech-language pathologist

    • School nurse

    • Audiologist

    • Special educator

    • School principal

29. Which of the following procedures gives the best information for diagnosing PVFMD?

    • Asthma tests

    • Pulmonary function tests

    • Direct visualization of the larynx when symptoms are present

    • Barium swallow

    • Cervical auscultation

30. Treatment for PVCMD can be divided into five phases. Which is the recommended order or sequence of phases?

    • Education and awareness, inhalation techniques, exhalation techniques, rhythm and relaxation, generalization

    • Education and awareness, exhalation techniques, inhalation techniques, rhythm and relaxation, generalization

    • Education and awareness, rhythm and relaxation, inhalation techniques, exhalation techniques, generalization

    • VRhythm and relaxation, education and awareness, inhalation techniques, exhalation techniques, generalization

    • Education and awareness, inhalation techniques, exhalation techniques, generalization, rhythm and relaxation

31. Response to Intervention may be the best service delivery option for the speech-language pathologist because

    • NSCC and PVCMD don't respond to traditional therapy techniques

    • NSCC and PVCDM can be treated successfully in only a few sessions

    • NSCC and PVCMD can be only be treated by a pulmonologist

    • NSCC and PVCMD can be treated by providing accommodations

    • NSCC and PVCMD cannot be treated by others