SPEECH PATHOLOGY PRAXIS 5331 TIPS + STUDY GUIDE

Hello there!

Good news – I PASSED THE PRAXIS! For you soon-to-be speechies out there, you get the capitalization required for that statement! I feel so unbelievably relieved and overjoyed by my copious amounts of free time! Well…I’m still finishing a grad program…so it’s not that much. BUT HEY! I want to give you some helpful hints for studying and taking the speech pathology praxis exam! Also…CHECK OUT MY PRAXIS STUDY GUIDE! It outlines how I studied for the test, and hopefully can serve as a good resource for you while you study.

– STUDYING:

  • Set boundaries for yourself. You are probably reading this because you’re crazy type A and have a super strong work ethic. WAY TO GO! But listen – don’t let the praxis control your life!!!! Did you see that? I said DON’T! It’s easy to think that every ounce of free time needs to be devoted to studying – but it doesn’t. You’re going to be a much better test-taker if you’re calm, cool, and collected. Set minimum and maximum study times for yourself. For instance, the weekend before I took the test, I knew I wanted to continue studying, (BECAUSE WHAT IF I JUST NEED TO KNOW 1 MORE THING!?!?!?) but I also didn’t want to exhaust myself with facts. So…I told myself that I would study for a minimum of 5 hours total for the entire weekend (Friday afternoon-Sunday night) but a maximum of 10. Do this, or you’ll drown in your notes.
  • Have an accountability partner/study buddy. My friend Kendra and I decided in December that we wanted to take the test early because we’re both getting married this summer and have showers and wedding details to do this Spring. There were so many times when I absolutely didn’t want to study BUT, I had committed to meet Kendra to go over a certain topic and so I needed to keep my word. We tried to prepare and study on our own during the week, then meet to quiz each other and talk over complicated things. It was also so helpful to know that someone was pretty much just as prepared as I was going into the test. Not that if you fail, then you’ll both fail, but it just gives you a sense of confidence that you’re not alone.
  • Pace yourself – but don’t be crazy. I started studying at the beginning of January and took the test the second week of March – 10 weeks total. Yes, it’s super overwhelming at the beginning, especially because you don’t know where to start. I broke my studying up into 10 sessions/weeks and committed to spending somewhere between 3 and 8 hours on that topic. Some topics were more difficult to spend time with than others (cough cough…audiology), but I wanted to make sure I had a good amount of familiarity with everything.
  • Make what you know WIDE, instead of DEEP. So you know how when you study for an exam for a class like hmmm motor speech disorders, you feel like you know like absolutely every detail about a subject? Yeah…don’t waste your time doing that for the praxis. The wider your knowledge is, the better off you’ll be. Do you need to know everything about a certain type of dysarthria or part of the brain? NO. Do you need to be familiar with several types of dysarthria and their various names and several parts of the brain? YES. I hope this makes sense. So here’s another example – the genetic syndromes were super overwhelming to me. Some of the practice questions asked the most obscure details that I had no idea how to answer. So…I told myself that I would know one thing about each disorder/disease. For instance, I knew that with Angelman syndrome, children often have a happy demeanor. I associated “Angelman” with “happy” – and that’s it. Be as familiar with as many terms as you can, because not every program uses every term out there. It wouldn’t hurt to even google some terms to find their synonyms. Of course, there are going to be some questions on the test that just make your jaw drop because you have absolutely no idea what the heck they’re talking about, but maybe – just maybe, you’ve heard that word before and it’ll help you at least reason through a good guess.
  • Take as many practice tests/quizzes as you can get your hands on. I purchased the $17 test from ETS and took the full test twice. I ended up doing better on the real thing, but the practice test was really helpful to give me confidence going into it. It’s weird – on the practice test, it gives you the option to pick more than one multiple choice (pretty much like make up your own “a+d only”) and I got almost all those questions wrong because I didn’t pick all the right ones. HAVE NO FEAR – the real test is straight-up multiple choice. Don’t worry.
  • Study in a variety of ways. For me, I like to say my notes out loud to myself and record them. Creepy, right!? But when I’m feeling like I don’t want to read anymore, I just hit play and “study” while I’m actually probably daydreaming. I also used Quizlet’s app on my iPhone. I made a few decks of cards, but there are a ton already out there. These were good when I just felt like browsing my phone and didn’t want to get in full study-mode.

-TEST DAY:

  • SLEEEEEEEEEEP the night beforehand. I was dumb and didn’t take into account that the day I took the test was the Monday after daylight savings time so I could not fall asleep for the life of me. Do whatever you can to relax and put your best foot forward for the morning-of.
  • Treat yo-self. (Anyone else love Parks and Rec?) Maybe for you, it means getting a manicure the day before or swinging by your favorite coffee shop the morning-of. I’m not kidding. Look good – feel good – test good…uhhh you get the point.
  • It’s not like you expect. Well, maybe after reading this you’ll know more of what to expect so my point isn’t so valid. The site where I took my test was NOTHING like I pictured. It was a general testing site where random people from all professions/studies/walks of life were taking all sorts of tests. I’m pretty sure the guy next to me was taking a truck driving test. The employees at the testing center really didn’t know anything about my test in particular – I asked where/when I would see my scores and they had no idea. They’re responsible for making sure you’re not hiding answers in your sleeve (they made me take off my scarf) and that you’re not causing a ruckus for other test-takers. I took my test in a cubicle at a computer screen. There were HUGE headphones, (like the ones lawncare people use) but I didn’t wear them because they hurt my head. Once you sit down, you have to walk through a little introductory thing that pretty much tells you how to click a mouse (and the test anxiety starts really kicking in here – cue sweaty palms). I had 2.5 hours to answer 132 questions. I’m pretty sure I finished going through all the questions in an hour, then got up to go to the bathroom (which you can only do once), and came back to my seat to review my answers. You can click “mark” for questions you definitely want to come back to, but I ended up just reviewing all of them to make sure I didn’t make any stupid mistakes. In total, I think it took me an hour and a half.
  • CHECK YOUR STATE REQUIREMENTS FOR THE SCORE YOU NEED OR ELSE YOU’LL FREAK OUT! In Michigan (and most other states), you need a 162. I only knew this because we talked about it in class the week before. Once you submit the test, it takes like 2 seconds and then spits out a standard score on your screen. All my screen said was “188.” THAT’S RIGHT – it doesn’t say the word “pass” or “fail” anywhere! Make sure you know what the minimum score is, so that you’ll be confident when you pass!

I really hope this helps answer any questions you have and relieve some anxiety! Feel free to comment or message me with any other details! Best of luck to you!

Carrie

School SLP Random Tips!

I recently started my school-based practicum assignment for the semester – and I’m loving it! Kids are so fun! As I’m reflecting on the past two weeks (AND ORGANIZING MY LIFE!), I’m thumbing through little notes and tidbits from my supervisor I wrote down.

My supervisor’s structure is AMAZING. On the first day of the week she sees students, she calls it “folder day.” This means that once a student enters the speech room, they select their folder out of a filing cabinet. My supervisor stuffs folders every marking period with relevant worksheets or target words for their goals. GUYS – THIS MEANS NO PLANNING. When students are making progress toward their goals, folder sheets are updated to be more goal-oriented. Once a student finds their folder, they receive a sticker to add to it, and out comes a perfectly planned worksheet for us to do! My supervisor writes the student’s name at the top of the worksheet and gives easy parent instructions for how to elicit the correct response or how to reinforce goals at home! The worksheet gets completed during the session, data is logged (9/10 /sl/ blend words @ word level, 7/10 @ sentence level), and the now-familiar worksheet travels home to parents! If a student frequently struggles with practicing at home, my supervisor often rewards them with some sort of a prize if they bring back their homework with a parent signature. On non-folder days, therapy looks a little more traditional, with card games, apps, Super-Duper board games, book reading, and so on.

When working with school-age kiddos, here are some helpful hints:

  • Always make the expectations known, even when they’re as little as keeping your feet on the floor when sitting on an exercise ball!
  • Provide visual feedback whenever possible.
  • Give kids the opportunity to tell you their answer (auditory comprehension) when they know, not just when you’re done reading. Give them a chance to respond and be successful immediately.
  • MODEL, MODEL, MODEL. My supervisor does a fantastic job of always taking the first turn when playing games or doing just about everything. For instance, when a student enters her room, she tells them, “My news is that _____. What’s your news?” This gives kids an opportunity to feel valued for what’s going on outside of the speech room, and also gives you an opportunity to hear their carryover in both speech and language.
  • Don’t just let stimuli words be stimuli words – ask questions, describe meanings, and so on.
  • Support teachers (especially angel Kindergarten teachers who I now respect to the nth degree) by giving students another opportunity to practice sight-word books. This will also allow you to see carryover with sounds and language. Also practice rhyming words.
  • Practice basic identifying information for students struggling with intelligibility. Because this information is so relevant for their safety, you’ll be able to reinforce target sounds by practicing family names, addresses, phone numbers and so on.
  • Remember a hierarchy when giving kids success. For instance – make sure they’re able to distinguish it in YOUR production before you expect them to distinguish correct and incorrect productions in their own speech.
  • Hypotheticals are your best friend. You can see so much language formation when you ask those “what if…” questions.
  • Practicing locatives is a kid’s favorite game of Simon Says. Who knew putting a highlighter on top of your head could be so much fun?
  • If a kid is interested in his/her performance, give them feedback immediately and have them rate their performance.
  • HEADBANDZ IS AWESOME. I also love Look Who’s Listening (I think it’s Super Duper).
  • Don’t wait the whole session, but you’d be surprised with what kids will come up with if you give them extra processing time instead of just feeding them the answer right away.
  • Maybe this is dumb, but if you’re a grad student and haven’t gotten your hands on your state guidelines yet, DO IT!

This is probably word vomit – but I hope this helps!

Acute Rehab Treatment Ideas!

I spent my first semester of off-campus internships on an acute rehabilitation unit with some fantastic people! I learned so much from a phenomenal supervisor and this post is more or less my way to remember it.

Some basics to keep in mind:

  • Make the beginning and end of every session successful for the patient – no matter what.
  • Educate patients, and be able to justify why you’re doing the activity, but don’t over-educate.
  • Be willing to change the pace/level/challenge of the activity at any time! Have ideas ready for the next step whether the patient succeeds or fails.

General therapy go-to tasks:

  • Problem-solving cards (describing functional problem, such as a child holding a sharp knife, then explaining what to do to solve the problem)
  • Playing cards!
    • A girl’s best friend (memory)
    • Rule-sort (ex: cards with “t” in one pile, “no t” in another)
    • Crazy 8’s
    • Nertz
  • Blink (card game)
  • WALC-Cognition book of worksheets
  • Medicine management task (written directions on pill bottles with beads inside, required to fill daily pill box)
  • Cognitive-lingustic therapy book (name opposites, divergent naming)
  • iPad apps!
    • Flow
    • Clockwork Brain
    • Word Jewels

Voice, Say What!?

Sensory symptoms of voice disorders may include:

  • Frequent throat clearing
  • Frequent coughing
  • Vocal fatigue that progresses with use of the voice
  • Irritation or pain in the voice box or throat
  • Strain, bulging, or tenderness of neck muscles
  • Swelling of veins of the neck
  • Feeling of a foreign substance or “lump” in throad
  • Ear irritation, tickling, ear ache
  • Frequent sore throats
  • A tickling, soreness, or burning sensation in the throat
  • Scratchy or dry throat
  • Tension and/or tightness in the throat
  • A feeling that talking is an effort
  • Pain or difficulty swallowing
  • Pain or burning sensation at the base of the tongue

Although the term “voice” is imprecise itself, voice disorders are those in which the laryngeal mechanism is effected. Specifically, voice disorders “refers to abnormal pitch, loudness, or vocal quality according to sex, age, status, temporary physiological state, purpose of the speaker, and elements of the speaking circumstances.” (pg. 269) In order to conceptualize voice and voice disturbances, we must consider the auditory characteristics of pitch, loudness, and quality. Disorders in voice relate to the physical systems in place, particularly the respiratory, phonatory, and resonatory-articulatory systems. The respiratory system must be able to:

  1. Provide an adequate amount of air so that the speaker can sustain speech with ease to allow for natural phrasing and prosodic factors
  2. Provide adequate control of the flow of air so that the mechanism can, when necessary, either initiate or arrest the speech signal
  3. Provide an airstream that is not so indebted to active muscle contraction that it encourages unnecessary muscle tension in the respiratory and phonatory mechanisms
  • Aphonia – total lack of voice

Haynes, W. O., & Pindzola, R. H. (2012). Diagnostics and evaluation in speech pathology (8th ed., pp 267-306). Pearson.

Voice Assessment

The areas to assess for voice disorders includes:

  • Case history (including referral input, client interview, client’s own impact ratings)
  • Perceptual vocal assessment
  • Acoustic analyses (low and/or high tech)
  • Aerodynamic analysis (when available)
  • Visual assessment
  • Trial therapy probes

Sample interview questions to ask in the case history intake include:

  • What are your voice concerns?
  • When did these voice issues begin?
  • Did this begin suddenly or develop slowly?
  • What conditions surrounded the onset of these vocal concerns?
  • When is your voice better? When is it worse?
  • Describe the daily use of your voice.
  • Are there specific situations when voice trauma occurs?
  • Describe your general health.
  • What medications do you take?
  • What has your doctor told you about your voice?

Formal tests for voice disorders include:

  • The Boone Voice Program for Adults (3rd ed.)
  • The Boone Voice Program for Children (2nd ed.)
  • Systematic Assessment of Voice
  • Voice Assessment Protocol for Children and Adults

Initial treatment for voice disorders might include:

  • Reposturing and resonant facilitating techniques, such as: Gutzmann lateral compression of thyroid lamina, head turning or tilting, soft glottal attacks, singing/humming, relaxation of musculature/reduction of tension, and/or easy, resonant counting

Initial goals might include:

  • The client will self-recognize vocal fry or fatigue 75% of the time without clinician cuing.
  • The client will produce sustained voice for 10 seconds 80% of the time with mild clinician cuing.

Haynes, W. O., & Pindzola, R. H. (2012). Diagnostics and evaluation in speech pathology (8th ed., pp 215-237). Pearson.

Voice Education

http://www.Dysphonia.org/ — This site is home to the National Spasmodic Dysphonia Assiciation. It provides general information about dysphonia for the public and also aims to advocate for and connect members.

http://www.asha.org/uploadedFiles/public/speech/disorders/VoiceTherapyFAQs.pdf — This page is from the American Speech, Language, and Hearing Association and aims to educate the public about voice therapy. It answers frequently asked questions and gives the basics of the anatomical structure and production of voice.

http://www.maryfreebed.com/VoiceTherapy — Mary Free Bed is a rehabilitation center in Grand Rapids, Michigan. This page gives you everything you might need to know about their voice therapy programs and allows you to find answers for receiving services.

Voice Resources for Professionals

http://www.asha.org/slp/clinical/voice-disorders/ — This ASHA page gives descriptions of all that SLPs might encounter with voice disorders. It includes an extensive list of policies and reports for anything related to voice.

http://www.asha.org/uploadedFiles/slp/healthcare/AATVoiceEvaluation.pdf — This is a document from the American Speech, Language, and Hearing Association that may be used by SLPs across the country. It’s a specific voice evaluation form that may be used when seeing someone with a potential voice disorder for the first time.

http://www.asha.org/assessments.aspx — This is a great resource for SLPs completing assessments. If you choose to search “voice,” it provides a list of possible vocal assessments that may be used for a variety of clients.