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. 5–18)

1. How can metatherapy help the clinician's understanding of the patient?

   • By giving insight into the patient's relationship with their voice and potential motivation for (vocal) change.

   • By explicitly promoting knowledge of anatomy and physiology.

   • By offering guidance on physiologic therapy techniques.

   • By giving recommendations for frequency of vocal practice.

   • By teaching patients to recognize the most important elements of the Rehabilitation Treatment Specification System (RTSS) framework.

2. All of the following are major themes and goals of metatherapy except for which one?

   • Modified patient knowledge about the process of vocal improvement.

   • Modified patient beliefs about their role in treatment.

   • Modified patient beliefs about the volitional aspects of voicing.

   • Modified patient attitudes regarding the relationship between their voice and sense of identity.

   • Modified patient understanding of vocal fold vibratory physiology.

3. All RTSS-based treatment theories are made up of the following threepart treatment components:

   • Ingredients, mechanism(s) of action, skills, and habits.

   • Ingredient(s), target, broad aim(s).

   • Ingredient(s), target, mechanism(s) of action.

   • Organ functions, skills, and habits, representations treatment components.

   • Treatment theory, ingredients, and targets.

4. When a clinician applies a treatment theory that lacks specificity, one likely outcome is that:

   • Other clinicians are better able to follow their treatment plan.

   • The connections that can be drawn about changes in voice due to therapy become circular.

   • The patient feels less confused in therapy.

   • The patient gains confidence in their own ability to meet their voice goals.

   • The treatment approach can easily pivot as needed.

5. Metatherapy maps onto the RTSS at which of the following levels?

   • Ingredients only.

   • Mechanisms of action only.

   • Targets only.

   • Broad aims only.

   • To some extent, at each of the above levels.

   Article Two (pp. 19–31)

6. What are the three factors of the triadic model of reciprocal causation?

   • Internal.

   • External.

   • Behavioral.

   • Emotional.

   • A-C.

7. Difficulty replicating the target technique outside of therapy is:

   • A common barrier to practice.

   • A problem that can be reduced by providing video models or instructions.

   • A sign that the therapy approach may be too difficult for the patient.

   • An eventual barrier to generalization.

   • All of the above.

8. Internal factors that can influence adherence behavior include:

   • Self-efficacy.

   • Goal commitment.

   • The therapeutic alliance.

   • Social support.

   • A-C.

9. Self-efficacy pertains to one's

   • Self-esteem in performing a task.

   • Self-concept when performing a task.

   • Confidence in performing a task.

   • Commitment to performing a task.

   • All of the above.

10. Strategies to improve adherence include:

    • Establishing overall treatment goal agreement.

    • Convincing the patient to adhere to therapy.

    • Adjusting the treatment approach to the patient's self-efficacy.

    • Making voice homework more concrete.

    • All of the above.

    Article Three (pp. 32–40)

11. What is the primary stimulus for CTT?

    • Basic training gestures.

    • Pitch inflection.

    • Phrases.

    • Words.

    • Conversation.

12. What are the two main primary problems found in voice therapy that CTT was developed to address?

    • Adherence.

    • Relapse.

    • Irrelevancy.

    • Boredom.

    • Cost.

13. Which motor learning principal is not mentioned as a foundation to CTT?

    • Whole practice learning.

    • Increased cognitive effort.

    • Contextual relevance.

    • Salience and specificity.

    • Knowledge of results.

14. What is one of the two primary questions asked throughout CTT when differentiating different voice productions in conversation? (Choose all that apply)

    • Can you explain how you made that sound?

    • Did you feel a difference?

    • Did you taste a difference?

    • Did you see a difference?

    • How did you make the difference?

15. Compared to more traditional, hierarchical, voice therapy approaches for patients with benign vocal fold lesions or muscle tension dysphonia, CTT may be/may have:

    • More of a focus on breathing.

    • Larger pre-/posttherapy changes in patient-reported outcome measures.

    • More boring.

    • Less relevant to their communicative activities of daily living.

    • More expensive.

    Article Four (pp. 41–53)

16. Applying a functional voice approach to assessment and treatment will…

    • Support the desired needs of the client in their environment.

    • Support only the perspective of the speech-language pathologist in designing and implementing functional plans.

    • Not be effective because the approach is not meaningful for the client.

    • Not be supported by synchronous and synchronous telepractice methods.

    • Not include the needs of the client.

17. Define a functional voice approach.

    • An approach that considers only one context of voice assessment and therapy in one setting.

    • An approach that includes the essential voice assessment and therapy elements that are necessary to support the client's needs in their daily activities and environments while promoting a meaningful quality-of-life.

    • An approach that does not see the value of training new voices across multiple environments.

    • An approach that captures “snapshots” of voice assessment at only pre- and post-time points.

    • An approach that is clinician focused.

18. VoiceEvalU8 provides…

    • A voice assessment through app technology at only in-person sessions.

    • A voice assessment through app technology only through synchronous telepractice.

    • A voice assessment through app technology that the client completes either asynchronously on the client's own time or synchronously with the clinician either in-person or via telepractice.

    • A voice assessment through app technology only through asynchronous telepractice.

    • A voice assessment through typical in-person methods.

19. In the World Health Organization's International Classification of Functioning, Disability, and Health applied to voice…

    • The Body Functions and Structures and Activities and Participation use anatomy and physiology of the voice productions system to identify and train multiple new voices.

    • The Health Condition does not consider the client's desired outcomes for assessment and therapy.

    • The Environmental and Personal Factors do not determine all the vocal needs across environments.

    • The Activities and Participation uses voice quality targets only to train one new voice.

    • The Environmental and Personal Factors do not consider personal factors when creating functional care plans.

20. Telepractice…

    • Provides only the option of synchronous videoconferencing to facilitate training goals.

    • Does not facilitate training across settings, communicative partners, and communication interactions.

    • Is an effective method only during the COVID-19 pandemic to substitute for the cancellation of in-person services.

    • Offers the ability to assess and train voice in the client's environment through both synchronous and asynchronous methods.

    • Does not include synchronous and asynchronous options.

    Article Five (pp. 54–63)

21. Prior to the pandemic of 2020, use of telepractice to deliver speech pathology was:

    • Unproven.

    • Being offered selectively and formally studied.

    • Being offered only to adults.

    • Widely accepted.

    • Considered too expensive to execute.

22. Pediatric voice therapy…

    • Is a specialty area easily accessible to patients who need it.

    • Is always and easily offered within the public-school system.

    • Can be difficult to access for multiple reasons.

    • Is not a communication disorder of high concern.

    • Is only offered in medical centers.

23. “Jack” demonstrated:

    • A severe dysphonia accompanied by strain and effort.

    • A moderate dysphonia that would have resolved on its own.

    • That he was not able to fully participate in his treatment delivered via telepractice.

    • A type of voice disorder that should have been first treated surgically.

    • Complete ease establishing rapport with his clinician regardless of which delivery method they used.

24. “Alice” demonstrated:

    • Severe dysphonia accompanied by strain and effort.

    • No interest in any therapeutic approach.

    • That she was too young to participate in telepractice sessions.

    • Progressive success in responding to therapy delivered via telepractice.

    • She could sing for long periods of time.

25. A primary lingering concern for using telepractice to conduct voice evaluations and voice therapy to children includes:

    • HIPAA-related privacy issues.

    • FERPA-related privacy issues.

    • Medicare-related cost issues.

    • Acoustic fidelity and related VoIP issues.

    • COVID-19 PPE issues.

    Article Six (pp. 64–72)

26. ASHA prefers the term telepractice because:

    • Telemedicine is only for physicians.

    • It includes services in and out of health care settings.

    • SLPs can only participate in asynchronous service delivery.

    • We must always work to improve our clinical care.

    • It does not include educational components.

27. Early examples of SLPs engaged in telepractice found that:

    • The distant clinician could not reliably diagnose and treat the patient.

    • All clinicians felt positively about adapting their practice.

    • Most visits resulted in referrals for direct, in-person follow-up.

    • Both the distant and in-person clinicians agreed on observations, diagnosis, and recommendations for each patient.

    • Patients felt slighted by the telepractice visits.

28. Telepractice may be one solution to the problem of:

    • National health disparities.

    • Lack of access to care in rural areas.

    • So many Americans living in medically underserved areas.

    • Providing timely therapeutic services to those with mobility and transportation difficulties.

    • All of the above.

29. One major change to guidelines implemented by ASHA during the COVID-19 pandemic was:

    • An SLP may initiate voice therapy prior to stroboscopic evaluation of voice.

    • An SLP may diagnose aspiration without a modified barium swallow.

    • An SLP does not need to make any changes to practice during the COVID-19 pandemic.

    • An SLP may diagnose a voice disorder without a physician.

    • An SLP does not need to take a case history.

30. Which is not a barrier to telepractice:

    • Insurance coverage.

    • Technological difficulties.

    • The lack of stroboscopy.

    • Lack of SLP confidence.

    • Poor treatment results compared to in-person therapy.

    Article Seven (pp. 73–84)

31. Which is/are factor(s) that might put a speech-language pathologist at risk for a voice disorder?

    • Being female.

    • Modeling techniques.

    • High vocal demands.

    • Having a master's degree.

    • A, B, and C.

32. Which complaint is one that speechlanguage pathologists might have as a result of occupational voice use?

    • Pain in low back.

    • Vocal fatigue.

    • Xerostomia.

    • Postural fatigue.

    • Foot discomfort.

33. What is a nonmodifiable risk factor for speech-language pathologists developing vocal difficulties?

    • GERD.

    • Allergies.

    • Throat clearing.

    • Being female.

    • Vocal demands.

34. Which factor(s) can be modified to decrease the risk for speech-language pathologists developing vocal difficulties?

    • Age.

    • PPE use.

    • background noise.

    • speaking technique.

    • B, C, D.

35. Which option(s) positively modify the amount, timing, or intensity of biomechanical forces during voicing?

    • Vocal rest.

    • Resonant voice.

    • Increased loudness.

    • A, B.

    • A, B, C.

Publication History

Article published online:
17 February 2021