Introduction to communication disorders a lifespan evidence based perspective 5th edition owens test bank

Instructor’s Manual to accompany Introduction to Communication Disorders: A Lifespan Evidence-Based Perspective Fifth Edition Robert E.. COMMUNICATION DISORDERS  A communication dis

Instructor’s Manual

to accompany

Introduction to Communication Disorders:

A Lifespan Evidence-Based Perspective

Fifth Edition

Robert E Owens, Jr

College of St Rose

Kimberly E Farinella

Northern Arizona University

Dale Evan Metz

Retired from SUNY Geneseo

Copyright © 2015, 2011, 2007, 2003 by Pearson Education, Inc., Upper Saddle River, New Jersey 07458

All rights reserved Printed in the United States of America This publication is protected by Copyright and

permission should be obtained from the publisher prior to any prohibited reproduction, storage in a retrieval system,

or transmission in any form or by any means, electronic, mechanical, photocopying, recording, or likewise For information regarding permission(s), write to: Rights and Permissions Department

Pearson ® is a registered trademark of Pearson plc

Instructors of classes using Owens/Metz/Farinella’s Introduction to Communication Disorders: A Lifespan

Evidence-Based Perspective, 5e, may reproduce material from the instructor’s manual for classroom use

10 9 8 7 6 5 4 3 2 1 ISBN-10: 0133598306

ISBN-13: 9780133598308

www.pearsonhighered.com

Table of Contents Instructor’s Manual: p 2-91

Test Bank with Answer Key:

CHAPTER 1 THE FIELD, THE PROFESSIONALS, AND THE CLIENTS

Chapter Learning Goals

1 Describe communication impairment

2 Describe the roles of audiologists, speech/language pathologists, and speech, language, and hearing scientists

3 Outline the history of changing attitudes toward individuals with disabilities over the centuries and especially legislation over the past several decades

4 Describe how evidence-based practice (EBP) influences clinical decisions

Introduction

Communication is part of what makes us human We will explore the nature of communication

disorders in this text In the first chapter, we introduce the professionals who work with individuals who

have communication disorders In addition, the roles of other team members will be discussed, as well as evidence-based practice and a historical perspective of laws that mandate appropriate care

Content Outline

HELPING OTHERS TO HELP THEMSELVES

Reasons for becoming a SLP or audiologist vary from person to person Some may want to contribute to the general good of society, and others may have experience with individuals with communication

disorders in their family or circle of friends

COMMUNICATION DISORDERS

 A communication disorder may affect any and all aspects of communication; it may affect

hearing, language, and/or speech

 Speech disorder: Atypical production of speech sounds, interruption in the flow of speaking, or

abnormal production and/or absence of voice quality (pitch, loudness, resonance, and/or

duration)

 Language disorder: Impairment in comprehension and/or use of spoken, written, and/or other symbol systems

 Hearing disorder: A result of impaired sensitivity of the auditory or hearing system

 Central auditory processing disorders: Deficits in the processing of information from audible signals

 Communication disorders are NOT differences, such as dialectal differences or multilingualism

 Augmentative/alternative communication systems: Attempts often taught by SLPs to

compensate and facilitate for impaired communication using, for example, signing or digital

methods

THE PROFESSIONALS

 Audiologists: Measure hearing and identify, assess, manage, and prevent disorders of hearing (including auditory processing disorders) and balance They may dispense hearing aids

 Credentials for Audiologists

 Educational requirements are 3-5 years of professional education beyond the bachelor’s degree

 This culminates in a doctoral degree, either an AuD, PhD, or EdD in audiology

 ASHA CCC-A: Requires doctorate, professional experience, national exam

 State license is often needed and is frequently identical to ASHA CCC

 Speech-Language Pathologists: Identify, assess, treat, and prevent expressive and receptive

communication disorders in all modalities They provide services for swallowing disorders and may be involved in modifying dialects

 Credentials for SLPs

 Public schools require at least a bachelor’s degree, but most states require a master's degree Requirements vary from state to state

 ASHA CCC-SLP: Requires master's degree or doctorate, professional experience, professional development, national exam

 State license often needed and is frequently identical to ASHA CCC There may also be additional requirements for the state’s department of education school certification

 Speech, Language, and Hearing Scientists: Extend knowledge of human communication

processes and disorders They usually have doctorate degrees and are employed by universities, government agencies, industry, and research centers Some may also work clinically

♦ What Speech, Language, and Hearing Scientists Do

 Speech scientists may be involved in basic research exploring anatomy, physiology, and physics of speech-sound production

 Investigate the causes, prevention, and treatment of various speech impairments

 Development of computer-generated speech

 Language scientists may investigate the ways children learn language

 Conduct cross-cultural studies of language and communication

 Study how languages are changing

 Examine language disabilities and the nature of language disorders in children and adults

 Hearing scientists investigate the nature of sound, noise, and hearing

 They may help develop equipment for hearing assessment

 Develop techniques for testing infants or those with physical or psychological

impairments

 Develop and improve assistive listening devices

 Concerned with conservation of hearing and limiting environmental noise

 Professional Aides: Work with supervision to assist audiologists and SLPs Their titles,

educational requirements, and responsibilities vary amongst states that permit their employment They may work only with supervision and there are limits to the tasks in which they can be involved

 Related Professionals: A Team Approach: Teams can include family members, regular and

special education teachers, psychologists, social workers, physicians and other medical

personnel, and occupational, physical, and music therapists They may collaborate with physicists

and engineers

SERVICE THROUGH THE LIFESPAN

 Individuals with communication disorders may be of any age

 1 in 5 people has a disability, and the likelihood increases as we age

 Infants are screened for hearing loss and other disabilities as soon as they are born

 Babies and toddlers may exhibit developmental delay

 An interdisciplinary approach is necessary in the assessment and treatment of young children, and an IFSP is developed for each child, which is directed to the entire family

 Early intervention is highly valuable and may prevent later difficulties

 Preschoolers may attend a special school where professionals can address the child’s needs

 Almost half of all SLPs are employed in school systems

 School-age children with communication difficulties often experience academic and social

difficulties

 1.5 to 2 million Americans sustain a traumatic brain injury each year and may have subsequent communication or swallowing impairments

 In those over age 65, stroke, neurological disorders, and dementia may interfere with

communication and swallowing

 Hearing loss may affect at least one quarter of older adults

 Assumptions of EBP:

 Clinical skill grows from experience and current available data

 The SLP or audiologist seeks new therapeutic information to improve efficacy

♦ Professional, peer-reviewed journals are the best source of clinical evidence

♦ ASHA has established the National Center for Evidence-Based Practice in Communication Disorders, but comprehensive assessment and intervention guidelines are still works in progress

♦ Efficacy: The probability of benefit from an intervention under ideal conditions There are

three key elements:

 It refers to an identified population, not specific individuals

 The treatment should be focused and the population should be clearly identified

 The research should be conducted under optimal intervention conditions, although actual clinical conditions may be less than ideal

♦ Effectiveness: The probability of benefit from an intervention method under average

conditions It is what works in real-world application of intervention

♦ Efficiency: The quickest and least effortful method resulting in the greatest positive benefit

♦ Additional factors affecting clinical decision making include the clinician’s expertise,

experience, attitude, and motivation, client/family values and characteristics, and service delivery variables

♦ Providing the best intervention possible is of foremost concern Intervention options and supporting evidence should be discussed with clients and/or family members

COMMUNICATION DISORDERS IN HISTORICAL PERSPECTIVE

 Disorders are not new but attitudes toward them have changed throughout the centuries

 By the late 1700s, special residences were designed for individuals with specific disorders

 The first U.S “speech correctionists” were educators and others who took an interest in speech problems

 The first professional journal related to communication, The Voice, was established in 1879

 Early interest groups included teachers within the National Education Association and the

National Association of Teachers of Speech

 The American Academy of Speech Correction was formed in 1925, a precursor to ASHA

 Audiology became a profession in the 1920s and experienced a boom in the 1940s due to World War II veterans who were experiencing noise-induced hearing loss

 The American Coalition of Citizens with Disabilities was created in 1974

 Select federal mandates affecting people with communication disabilities:

 1975: Education for All Handicapped Children Act (EAHCA) (Public Law 94-142)

 Mandated that a free and appropriate public education (FAPE) must be provided for all handicapped children between ages 5 and 21

 1986: Education of the Handicapped Amendments (Public Law 99-457)

 Extended age of those served to cover children between the ages of birth and 5 years

 1990: Individuals with Disabilities Education Act (IDEA)

 Addressed the multicultural nature of the U.S

disabilities Federal legislation currently mandates services for people with disabilities

Suggested Resources Print Resources

Nicolosi, L., Harryman, E., & Kresheck, J (2003) Terminology of communication disorders: Speech,

language, and hearing (5th ed.) Baltimore: Williams & Wilkins

Peterson’s Guides (Ed.) (2013) Graduate & Professional Programs: An overview 2013 Princeton, NJ:

Peterson’s (published annually)

Singh, S (Ed.) (2000) Singular’s illustrated dictionary of speech-language pathology San Diego:

Singular

Audiovisual and Online

National Institute on Deafness and Other Communication Disorders (NIDCD): www.nidcd.nih.gov

American Academy of Audiology (AAA): http://www.audiology.org

American Speech-Language-Hearing Association (ASHA): http://asha.org

Acoustical Society of America (ASA): http://asa.aip.org

Peterson's Guide to Graduate and Professional Study: http://www.petersons.com/

Suggested Activities

1 Ask students why they are taking this course

2 Arrange for students to shadow a speech-language pathologist or audiologist for a day After writing a journal of their observations, students can compare notes in class

3 Have students interview a person with a communication disorder or have an individual visit the class How was this person's life affected by the disorder? What kind of help has the person received? Students can prepare additional questions

4 Project the ASHA website to demonstrate the available resources for students

5 Invite fellow faculty members to class to briefly describe their research projects to show students what speech, language, and hearing scientists in their department are involved in

CHAPTER 2 TYPICAL AND DISORDERED COMMUNICATION

Chapter Learning Goals

1 Explain the role of culture and environment in communication

2 Describe what is involved in human communication

3 Demonstrate how communication disorders may be classified

4 Name some types of communication disorders

5 Discuss and estimate the frequency of occurrence of communication disorders

6 Describe in general the assessment and intervention process

Content Outline

HUMAN COMMUNICATION

 The Social Animal

 Communication: An exchange of ideas between sender(s) and receiver(s)

 Sociolinguistics: How cultural identity, setting, and participants influence communication

 Cultural Identity

 Refers to our language and cultural communities (nationality, age, gender, ethnicity, etc.)

 Means of Communication

♦ Language: A socially shared tool that is used to represent concepts It uses arbitrary

symbols that are combined in rule-governed ways

 Grammar refers to the rules of a language

 Linguistic intuition is the recognition of "right" or "wrong" grammar by native speakers

 Generative means that each utterance is freshly created

 Dynamic means that languages change over time

 All languages have three primary components: Form, Content, and Use

 Form consists of phonology, morphology, and syntax

 Phonology is the sound system of a language

 Phonotactic rules specify how sounds may be arranged in words

 Morphology involves the structure of words

 Morphemes are the smallest grammatical units in a language

 Free morphemes may stand alone as a word

 Bound morphemes change the meaning of the original words and can only be

attached to free morphemes

 Syntax is how words are arranged in a sentence and the ways in which one word

may affect another

 Content consists of semantics

 Semantics refers to the content or meaning of language

 Semantic features are pieces of meaning that define a particular word

 Use consists of pragmatics, which is how and why we use language Pragmatic rules

vary with culture

♦ Speech: The process of producing the acoustic representation of language

 Articulation is the way speech sounds are formed

 Fluency is the smooth, forward flow of communication, influenced by rhythm and rate

 Rate is the speed at which we talk

 Rate and rhythm are components of prosody, or speech suprasegmentals

♦ Voice can reveal things about the speaker and the message

 Both the overall level of loudness and the loudness pattern within sentences and words are important

 Pitch is a listener’s perception of how high or low a sound is (frequency)

 Habitual pitch is the basic tone that an individual uses most of the time

 Intonation is the pitch movement within an utterance

♦ Nonverbal Communication: About 2/3 of human meaning exchange is nonverbal Nonverbal

encompasses both the suprasegmental aspects of speech and the nonvocal and

nonlinguistic aspect of communication

 Artifacts: How you look, your clothes, your possessions, music you listen to, etc

 Kinesics: The way we move our body, or body language

 Explicit movements are clearly defined

 Implicit movements are more general or subtle

 Space and Time

 Proxemics is the physical distance between people as it affects communication

 Tactiles are touching behaviors

 Chronemics is the effect of time on communication

COMMUNICATION THROUGH THE LIFESPAN

 Infants must first learn the rudiments of communication and begin to master speech

 The early establishment of communication between children and caregivers fosters the

development of speech and language, which influence the quality of communication

 This is complicated by physical, cognitive, and social development

 The key to becoming a communicator is being treated as one

 The process of learning speech and language is a social one that occurs through interactions of children and the people in their environment

 Every person’s speech and language continues to change until the end of life

 A competent communicator continues to adapt to changes in the language and in the

communication process

COMMUNICATION IMPAIRMENTS

 Communication disorders consist of disorders of speech (articulation, voice, resonance, fluency), oral neuromotor patterns of control and movement, language impairment, feeding and swallowing disorders, cognitive and social communication deficits, and hearing and processing difficulties

 May be categorized on the basis of whether reception, processing, and/or expression are

affected

 Etiology is the cause/origin of a problem, and may be used to classify a communication problem

♦ Faulty learning, neurological impairments, anatomical or physiological abnormalities,

cognitive deficits, hearing impairment, or damage to any part of the speech system

 Congenital: Present at birth

 Acquired: The result of illness, accident, or environmental circumstances later in life

 Severity is also used to characterize communication disorders, ranging from mild to profound

 Variations in communication are not impairments

 Dialects: Differences that reflect a particular regional, social, cultural, or ethnic identity

 A holistic approach to the diagnosis and treatment of people with communication impairments is

used in this text

 Language Disorders

 Disorders of Form

 Errors in sound use constitute a disorder of phonology

 Incorrect use of past tense or plural markers is an example of a disorder of morphology

 Syntactical errors include incorrect word order and run-on sentences

 May be due to sensory limitations, perceptual difficulties, limited exposure to correct models, etc

 Disorders of Content

 Limited vocabulary, misuse of words, or word-finding problems

 Difficulty understanding and using abstract language

 May be due to limited experience, concrete learning style, strokes, head trauma, or certain illnesses

 Disorders of Use

 Pragmatic impairments may stem from limited or unacceptable conversational, social, and narrative skills; deficits in spoken vocabulary; and/or immature or disordered

phonology, morphology, and syntax

 Might include difficulty staying on topic, providing inappropriate or incongruent responses

to questions, or continually interrupting the conversational partner

 Speech Disorders: May involve articulation, fluency, or voice

 Disorders of Articulation

 Articulation: The actual production of speech sounds

 It is not always easy to determine whether an individual’s speech-sound errors indicate

an impairment of phonology (a language problem) or articulation

 The causes of articulation disorders include neuromotor problems such as cerebral palsy, physical anomalies such as cleft palate, and faulty learning

 Dysarthria is a speech disorder caused by paralysis, weakness, or poor coordination of

the speech musculature

 Apraxia of speech is a speech disorder that is due to neuromotor programming

difficulties

 Disorders of Fluency

 The smooth, uninterrupted flow of speech is affected

 Developmental disfluency: Speech patterns common to young children (~age 3)

 Fillers: Examples include “er,” “um,” and “ya know.”

 Hesitations: Unexpected pauses

 Repetitions: Sounds or words are repeated, as in “g-go-go.”

 Prolongations: Excessively long duration, as in “wwwwwwwell.”

 Stuttering: When these speech behaviors exceed or are qualitatively different from

the norm or are accompanied by excessive tension, struggle, and fear

 Fluency disorders are generally first noticed before age 6

 Adult onset of stuttering can also occur

 The causes of nonfluent speech are typically unclear

 Voice Disorders

 Congenital physiological conditions can affect voice, but are relatively rare

 Vocal abuse: Excessive yelling, screaming, or loud singing Can result in hoarseness or

another voice disorder

 Habits such as physical tension, coughing, throat clearing, smoking, and drinking alcohol can disrupt normal voice production

 Can result in pathology such as polyps, nodules, or ulcers

 Other causes: Disease, trauma, allergies, and neuromuscular or endocrine disorders

 Hearing Disorders

 Deafness

 When a person’s ability to perceive sound is limited to such an extent that the auditory channel is not the primary sensory input for communication It may be congenital or acquired

 Interventions

 Total communication is considered the most effective

 Assistive listening devices, cochlear implants, and auditory training are helpful

 Hard of Hearing

 People who are hard of hearing depend primarily on audition for communication

 Hearing loss may be temporary or permanent

 Hearing loss is categorized in terms of severity, laterality, and type

 Severity may range from mild to severe

 The loss can be bilateral (involving both hears) or unilateral (involving one ear)

 The type of loss can be conductive, sensorineural, or mixed

 Conductive: Caused by damage to the outer or middle ear

 Sensorineural: Problems with the inner ear and/or auditory nerve

 Mixed: Both conductive and sensorineural losses

 Auditory Processing Disorders

 Individuals with APD may have normal hearing but difficulty understanding speech

♦ Difficulty keeping up with conversation, understanding speech in noise, discriminating and identifying speech sounds, and integrating speech with nonverbals

♦ Etiology is often unknown, but can be due to tumor, disease, or brain injury

♦ Can occur in children or adults

♦ May coexist with other disorders

 How Common Are Communication Disorders?

♦ What is "Normal"?

 Variability is the norm

 “Typical” is a better term when we mean “like most others of the same group.”

♦ Communication Disorders as Secondary to Other Disabilities

 Most communication disorders are secondary to other disabilities

 Children with cleft palate also have physical health problems

 People with cerebral palsy have more global motor deficits

 Children with learning disabilities may also have academic and social difficulties

♦ Estimates of Prevalence

 Prevalence: The number/percentage of people within a specified population who have a

particular disorder or condition at a given point in time

 About 17% of the U.S population has a communication disorder

 About 11% have a hearing loss

 About 6% have a speech, voice, or language disorder

 6-10 million Americans have swallowing disorders; many have communication

impairments

 The percentage of people with hearing loss increases with age

 Impairments of speech-sound and fluency are more common in children than adults and more common in males that females

 Speech disorders due to neurological disorders or brain and spinal cord injury occur more often among adults

 3-10% of Americans have voice disorders

 Language disorders occur in 8-12% of the preschool population and decreases through the school years

 5-10% of older adults experience language disabilities related to stroke or dementia DECIDING WHETHER THERE IS A PROBLEM

 Selection for assessment may come from referral from another professional or concerned adult or from a screening

 Adults may refer themselves

 Defining the Problem

♦ Assessment of communication disorders is the systematic process of obtaining

information from many sources, through various means, and in different settings to verify and specify communication strengths and weakness, identify possible causes of problems, and make plans to address them

♦ Diagnosis: Distinguishes an individual’s difficulties from the broad range of possible

problems

 Assessment Goals

♦ The primary goal of diagnosis is determining exactly what is wrong

♦ Diagnostic therapy: Working with the client for a time to obtain a clearer picture of strengths

and weaknesses

♦ If a problem exists, the SLP should determine severity

♦ Etiology (cause) should be determined

♦ Predisposing causes may include genetic factors

♦ Precipitating factors trigger a disorder

♦ Maintaining or perpetuating causes continue or add to the problem

♦ Recommendations are part of the assessment report

♦ The SLP makes a prognosis (informed prediction of an outcome) regarding whether the

problem will persist if no intervention occurs and what the likely outcome is if a course of therapy or other treatment plan is followed

 Assessment Procedures

♦ Authentic data: Actual real-life information

♦ A clinician should use a variety of procedures

♦ Norm referenced tests: Yield scores that are used to compare a client with a sample of

 Most ASHA assessment guidelines are described in the following chapters

INTERVENTION WITH COMMUNICATION DISORDERS

 Providing culturally responsive intervention is extremely important for children from culturally linguistically diverse backgrounds

 Intervention is influenced by the nature and severity of the disorder, the age and status of the client, environmental considerations, and personal/cultural characteristics of client and clinician

 ASHA has established the National Center for Treatment Effectiveness in Communicative

Disorders and is currently coordinating a National Institutes of Health-funded effort to promote clinical research that will support EBP

 Objectives of Intervention

♦ The client should show improvement and this should generalize

♦ What has been learned should be largely automatic

♦ The client must be able to self-monitor

♦ The client should make optimum progress in the minimum amount of time

♦ Intervention should be sensitive to the personal and cultural characteristics of the client

♦ A statement that specifies the target behavior in an observable and measurable way

♦ A: Actor: Who is expected to do the behavior?

♦ B: Behavior: What is the observable and measurable behavior?

♦ C: Condition: What is the context or condition of the behavior?

♦ D: Degree: What is the targeted degree of success?

 Clinical Elements

♦ Direct Teaching

 Behavior modification: A systematic method of changing behavior

 The SLP provides a stimulus and reinforces the response if it is correct or provides

corrective feedback if it is not

♦ Family and Environmental Involvement

 Family members may be asked to help the client with specific activities at home to foster carryover

 Support groups can provide an avenue to practice what has been learned in therapy,

share feelings about the disability, and maintain communication skills once formal treatment has been terminated

 Measuring Effectiveness

♦ Post-therapy tests can be used to determine whether clients have met their objectives

♦ If therapy has been effective, the client is successful in generalizing the learned skills, can self-correct, and experiences automaticity

 Follow-up and Maintenance

♦ Upon dismissal, the client or family should be encouraged to return if there is a need

♦ A regular follow-up schedule can be established

♦ Booster treatment may be provided if needed

Assessment of communication disorders requires an understanding of communication in context

Referrals and screenings are the primary ways in which individuals are selected for assessment

Assessment and treatment function in a cyclical fashion, with one influencing the other Successful intervention often uses a team approach that involves family members as well as professionals

Suggested Resources Print Resources

Axtell, R (1998) Gestures: The do’s and taboos of body language around the world (Rev ed.) New

York: Wiley

Hirsh-Pasek, K., & Golinkoff, R (1999) The origins of grammar: Evidence from early language

Cambridge, MA: MIT Press

Ruben, B., & Stewart, L (2006) Communication and human behavior (5th ed.) Boston: Pearson

Education

Audiovisual and Online

The ASHA website (www.asha.org) discusses various disorders that affect children and adults

Evidence based practice: http://www.asha.org/members/ebp/

Dynamic assessment: http://www.asha.org/practice/multicultural/issues/Dynamic-Assessment

Suggested Activities

1 Identify the different speech communities represented in your class What variations in

communication can be noted based on this?

2 Based on student experience, attempt to determine the prevalence of communication disorders Consider: How many students have a disorder? How many have relatives in this situation? Friends? Acquaintances? What percentage is this of the estimated pool of individuals? What type of disorder is most common? What are the weaknesses in this procedure?

3 Use a computer and projector to visit websites for various disabilities Often sites have video links with examples of various disorders

4 Have students sign up to observe live therapy sessions or play video clips in class to illustrate both assessment and treatment procedures

5 Bring formal assessments to class and pass around for students to get an idea of the types of stimuli used

CHAPTER 1 THE FIELD, THE PROFESSIONALS, AND THE CLIENTS

1 A communication disorder may affect

a Hearing

b Language

c Speech

d All of the above

2 “Atypical production of speech sounds, interruption in the flow of speaking, or abnormal production and/or absence of voice quality” is the definition of a

a Speech disorder

b Language disorder

c Hearing disorder

d Central auditory processing disorder

3 “Impairment in comprehension and/or use of spoken, written, and/or other symbol systems” is the definition

of a

a Speech disorder

b Language disorder

c Hearing disorder

d Central auditory processing disorder

4 “A result of impaired sensitivity of the auditory system” is the definition of a

a Speech disorder

b Language disorder

c Hearing disorder

d Central auditory processing disorder

5 “Deficits in the processing of information from audible signals” is the definition of a

a Speech disorder

b Language disorder

c Hearing disorder

d Central auditory processing disorder

6 Attempts taught by SLPs to compensate and facilitate for impaired communication using various methods

a Dialects

b Augmentative/alternative communication

c Multilingualism

d All of the above

7 The professionals who measure hearing and identify, assess, manage, and prevent disorders of hearing and balance are

8 The professionals who identify, assess, treat, and prevent expressive and receptive communication disorders,

as well as provide services for swallowing disorders and dialect modification are

10 The entry-level degree for an audiologist is currently

a Bachelor’s degree in audiology

b Master’s degree in audiology

c Doctoral degree (AuD, PhD, or EdD in audiology)

d Associate’s degree in audiology

11 The degree required for speech/language pathologists to earn the ASHA CCC is currently

a Associate’s degree

b Bachelor’s degree

c Master’s degree

d Bachelor’s degree plus a teaching certificate

12 Professional aides can

a Work with supervision to assist audiolgists and SLPs

b Conduct treatment independently

c Conduct evaluations independently

d Independently write all evaluation reports for the SLP or audiologist

13 Related professionals include

a 1 in 5 people has a disability

b 1 in 10 people has a disability

c 1 in 20 people has a disability

d 1 in 50 people has a disability

15 Infants are screened for hearing loss and other disabilities

a As soon as they are born

b Within the first week of birth

c Within the first month of birth

d If they show signs of abnormal development

16 What do speech, language, and hearing scientists do?