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DOI: 10.1055/s-0041-1725200
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)
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How can metatherapy help the clinician's understanding of the patient?
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By giving insight into the patient's relationship with their voice and potential motivation for (vocal) change.
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By explicitly promoting knowledge of anatomy and physiology.
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By offering guidance on physiologic therapy techniques.
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By giving recommendations for frequency of vocal practice.
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By teaching patients to recognize the most important elements of the Rehabilitation Treatment Specification System (RTSS) framework.
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All of the following are major themes and goals of metatherapy except for which one?
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Modified patient knowledge about the process of vocal improvement.
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Modified patient beliefs about their role in treatment.
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Modified patient beliefs about the volitional aspects of voicing.
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Modified patient attitudes regarding the relationship between their voice and sense of identity.
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Modified patient understanding of vocal fold vibratory physiology.
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All RTSS-based treatment theories are made up of the following threepart treatment components:
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Ingredients, mechanism(s) of action, skills, and habits.
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Ingredient(s), target, broad aim(s).
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Ingredient(s), target, mechanism(s) of action.
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Organ functions, skills, and habits, representations treatment components.
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Treatment theory, ingredients, and targets.
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When a clinician applies a treatment theory that lacks specificity, one likely outcome is that:
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Other clinicians are better able to follow their treatment plan.
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The connections that can be drawn about changes in voice due to therapy become circular.
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The patient feels less confused in therapy.
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The patient gains confidence in their own ability to meet their voice goals.
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The treatment approach can easily pivot as needed.
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Metatherapy maps onto the RTSS at which of the following levels?
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Ingredients only.
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Mechanisms of action only.
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Targets only.
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Broad aims only.
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To some extent, at each of the above levels.
Article Two (pp. 19–31)
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What are the three factors of the triadic model of reciprocal causation?
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Internal.
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External.
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Behavioral.
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Emotional.
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A-C.
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Difficulty replicating the target technique outside of therapy is:
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A common barrier to practice.
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A problem that can be reduced by providing video models or instructions.
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A sign that the therapy approach may be too difficult for the patient.
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An eventual barrier to generalization.
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All of the above.
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Internal factors that can influence adherence behavior include:
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Self-efficacy.
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Goal commitment.
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The therapeutic alliance.
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Social support.
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A-C.
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Self-efficacy pertains to one's
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Self-esteem in performing a task.
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Self-concept when performing a task.
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Confidence in performing a task.
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Commitment to performing a task.
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All of the above.
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Strategies to improve adherence include:
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Establishing overall treatment goal agreement.
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Convincing the patient to adhere to therapy.
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Adjusting the treatment approach to the patient's self-efficacy.
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Making voice homework more concrete.
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All of the above.
Article Three (pp. 32–40)
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What is the primary stimulus for CTT?
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Basic training gestures.
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Pitch inflection.
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Phrases.
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Words.
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Conversation.
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What are the two main primary problems found in voice therapy that CTT was developed to address?
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Adherence.
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Relapse.
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Irrelevancy.
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Boredom.
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Cost.
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Which motor learning principal is not mentioned as a foundation to CTT?
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Whole practice learning.
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Increased cognitive effort.
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Contextual relevance.
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Salience and specificity.
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Knowledge of results.
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What is one of the two primary questions asked throughout CTT when differentiating different voice productions in conversation? (Choose all that apply)
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Can you explain how you made that sound?
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Did you feel a difference?
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Did you taste a difference?
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Did you see a difference?
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How did you make the difference?
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Compared to more traditional, hierarchical, voice therapy approaches for patients with benign vocal fold lesions or muscle tension dysphonia, CTT may be/may have:
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More of a focus on breathing.
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Larger pre-/posttherapy changes in patient-reported outcome measures.
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More boring.
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Less relevant to their communicative activities of daily living.
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More expensive.
Article Four (pp. 41–53)
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Applying a functional voice approach to assessment and treatment will…
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Support the desired needs of the client in their environment.
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Support only the perspective of the speech-language pathologist in designing and implementing functional plans.
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Not be effective because the approach is not meaningful for the client.
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Not be supported by synchronous and synchronous telepractice methods.
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Not include the needs of the client.
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Define a functional voice approach.
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An approach that considers only one context of voice assessment and therapy in one setting.
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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.
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An approach that does not see the value of training new voices across multiple environments.
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An approach that captures “snapshots” of voice assessment at only pre- and post-time points.
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An approach that is clinician focused.
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VoiceEvalU8 provides…
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A voice assessment through app technology at only in-person sessions.
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A voice assessment through app technology only through synchronous telepractice.
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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.
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A voice assessment through app technology only through asynchronous telepractice.
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A voice assessment through typical in-person methods.
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In the World Health Organization's International Classification of Functioning, Disability, and Health applied to voice…
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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.
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The Health Condition does not consider the client's desired outcomes for assessment and therapy.
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The Environmental and Personal Factors do not determine all the vocal needs across environments.
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The Activities and Participation uses voice quality targets only to train one new voice.
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The Environmental and Personal Factors do not consider personal factors when creating functional care plans.
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Telepractice…
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Provides only the option of synchronous videoconferencing to facilitate training goals.
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Does not facilitate training across settings, communicative partners, and communication interactions.
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Is an effective method only during the COVID-19 pandemic to substitute for the cancellation of in-person services.
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Offers the ability to assess and train voice in the client's environment through both synchronous and asynchronous methods.
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Does not include synchronous and asynchronous options.
Article Five (pp. 54–63)
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Prior to the pandemic of 2020, use of telepractice to deliver speech pathology was:
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Unproven.
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Being offered selectively and formally studied.
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Being offered only to adults.
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Widely accepted.
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Considered too expensive to execute.
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Pediatric voice therapy…
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Is a specialty area easily accessible to patients who need it.
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Is always and easily offered within the public-school system.
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Can be difficult to access for multiple reasons.
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Is not a communication disorder of high concern.
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Is only offered in medical centers.
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“Jack” demonstrated:
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A severe dysphonia accompanied by strain and effort.
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A moderate dysphonia that would have resolved on its own.
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That he was not able to fully participate in his treatment delivered via telepractice.
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A type of voice disorder that should have been first treated surgically.
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Complete ease establishing rapport with his clinician regardless of which delivery method they used.
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“Alice” demonstrated:
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Severe dysphonia accompanied by strain and effort.
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No interest in any therapeutic approach.
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That she was too young to participate in telepractice sessions.
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Progressive success in responding to therapy delivered via telepractice.
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She could sing for long periods of time.
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A primary lingering concern for using telepractice to conduct voice evaluations and voice therapy to children includes:
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HIPAA-related privacy issues.
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FERPA-related privacy issues.
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Medicare-related cost issues.
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Acoustic fidelity and related VoIP issues.
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COVID-19 PPE issues.
Article Six (pp. 64–72)
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ASHA prefers the term telepractice because:
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Telemedicine is only for physicians.
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It includes services in and out of health care settings.
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SLPs can only participate in asynchronous service delivery.
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We must always work to improve our clinical care.
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It does not include educational components.
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Early examples of SLPs engaged in telepractice found that:
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The distant clinician could not reliably diagnose and treat the patient.
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All clinicians felt positively about adapting their practice.
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Most visits resulted in referrals for direct, in-person follow-up.
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Both the distant and in-person clinicians agreed on observations, diagnosis, and recommendations for each patient.
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Patients felt slighted by the telepractice visits.
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Telepractice may be one solution to the problem of:
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National health disparities.
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Lack of access to care in rural areas.
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So many Americans living in medically underserved areas.
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Providing timely therapeutic services to those with mobility and transportation difficulties.
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All of the above.
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One major change to guidelines implemented by ASHA during the COVID-19 pandemic was:
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An SLP may initiate voice therapy prior to stroboscopic evaluation of voice.
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An SLP may diagnose aspiration without a modified barium swallow.
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An SLP does not need to make any changes to practice during the COVID-19 pandemic.
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An SLP may diagnose a voice disorder without a physician.
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An SLP does not need to take a case history.
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Which is not a barrier to telepractice:
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Insurance coverage.
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Technological difficulties.
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The lack of stroboscopy.
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Lack of SLP confidence.
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Poor treatment results compared to in-person therapy.
Article Seven (pp. 73–84)
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Which is/are factor(s) that might put a speech-language pathologist at risk for a voice disorder?
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Being female.
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Modeling techniques.
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High vocal demands.
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Having a master's degree.
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A, B, and C.
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Which complaint is one that speechlanguage pathologists might have as a result of occupational voice use?
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Pain in low back.
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Vocal fatigue.
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Xerostomia.
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Postural fatigue.
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Foot discomfort.
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What is a nonmodifiable risk factor for speech-language pathologists developing vocal difficulties?
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GERD.
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Allergies.
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Throat clearing.
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Being female.
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Vocal demands.
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Which factor(s) can be modified to decrease the risk for speech-language pathologists developing vocal difficulties?
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Age.
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PPE use.
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background noise.
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speaking technique.
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B, C, D.
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Which option(s) positively modify the amount, timing, or intensity of biomechanical forces during voicing?
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Vocal rest.
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Resonant voice.
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Increased loudness.
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A, B.
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A, B, C.
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Publication History
Article published online:
17 February 2021
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