Praxis SLP 5331 Exam Flashcards

Q: How is the Praxis 5331 blueprint weighted across domains?

ETS's official study companion divides the exam evenly into three domains: Foundations and Professional Practice, Screening/Assessment/Evaluation/Diagnosis, and Planning/Implementation/Evaluation of Treatment - each worth about 33% of the 132 scored items. Balanced study time across all three areas matters more than over-preparing any single disorder type.

Q: What score do I need to pass Praxis 5331 for ASHA certification?

ASHA's Council for Clinical Certification currently requires a score of 162 (on the 100-200 scale) for CCC-SLP eligibility. State licensure boards may use the same score or set their own rules, so confirm your specific state requirement in addition to ASHA's.

Q: How long is a Praxis 5331 score valid for certification?

ASHA only accepts scores reported within 5 years of your certification application. Scores older than 5 years cannot be used for initial CCC-SLP certification, so plan your testing timeline relative to when you'll finish your clinical requirements.

Q: What happens if I fail Praxis 5331 - how soon can I retake it?

ETS requires a 28-day wait before retaking the same Praxis test, and this wait applies every time regardless of how many prior attempts you've had - there is no separate escalating wait after a third failure like some other certification exams use. As of the 2025-2026 testing year, ETS also introduced a 'Free After 3' program that waives the fee for a fourth attempt if your first attempt was on or after October 1, 2025 and all attempts are reported within 5 years.

Q: Is the Praxis 5331 pass rate published?

No - neither ETS nor ASHA currently publishes a public pass rate for the Speech-Language Pathology (5331) exam. Focus your prep on blueprint coverage and practice performance rather than chasing an unpublished benchmark.

Q: Why do developmental sound acquisition ages (Shriberg Early-8, Middle-8, Late-8) show up so often on Praxis 5331?

Foundations questions frequently test whether you can tell typical developmental sound errors from atypical ones. The 'y' glide (as in yes) is an Early-8 sound mastered earliest, while the 'g' stop (as in go) is a later-developing Middle-8 sound - mixing these two up is one of the most common exam traps in this content area.

Question 1

By what age do most typically developing children produce their first true words?

Accepted Answer

Around 12 months. This follows the prelinguistic stage (cooing, babbling) and marks the onset of intentional, referential communication that examiners use as an early developmental benchmark.

Question 2

What two language milestones typically occur between 18 and 24 months?

Accepted Answer

A roughly 50-word expressive vocabulary is reached near 18 months, and two-word combinations ('more juice,' 'daddy go') begin between 18 and 24 months, signaling the shift from single words to early syntax.

Question 3

The Early-8 developmentally acquired sounds include the glide spelled 'y' (as in yes) - not the sound spelled 'g' (as in go). Why does this distinction matter on the exam?

Accepted Answer

Early-8 sounds (m, b, the 'y' glide, n, w, d, p, h) are mastered earliest. The voiced velar stop /g/ is a later-developing sound and is NOT part of the Early-8 group - test items often swap 'y' and 'g' to check whether you know the glide, not the stop, belongs to the earliest group.

Question 4

Which consonants make up the Middle-8 group of developmentally acquired sounds, and by what age are they typically mastered?

Accepted Answer

t, ng (as in sing), k, g, f, v, the 'ch' affricate, and the 'j' affricate (as in judge) are the Middle-8, typically mastered around age 5;6 - after the Early-8 but before the Late-8. Note this 'j' affricate is a different sound from the Early-8 'y' glide despite the similar letters, and /g/ is a Middle-8 sound (not Early-8).

Question 5

Which sounds make up the Late-8 group (last to fully develop), and by roughly what age?

Accepted Answer

The Late-8 - sh, s, z, both 'th' sounds (voiceless as in think, voiced as in this), l, r, and 'zh' (as in measure) - are the latest-developing sounds, typically mastered by ages 7-8. A child still misarticulating these at age 5 is not necessarily disordered.

Question 6

Cranial nerve V (trigeminal) - what speech/swallow functions does it control?

Accepted Answer

Jaw closure (muscles of mastication) and facial/oral sensation. Damage impairs chewing strength and the sensory feedback needed for safe bolus control.

Question 7

Cranial nerve VII (facial) - what speech/swallow functions does it control?

Accepted Answer

Lip movement and facial expression (orbicularis oris and other facial muscles), plus taste to the anterior two-thirds of the tongue. Damage causes labial weakness that affects bilabial sounds and lip seal for feeding.

Question 8

Cranial nerve IX (glossopharyngeal) - what speech/swallow functions does it control?

Accepted Answer

Pharyngeal sensation and elevation, plus taste and general sensation to the posterior third of the tongue. It also carries the sensory limb of the gag reflex.

Question 9

Why is the vagus nerve (CN X) considered the highest-risk cranial nerve for swallowing and voice?

Accepted Answer

CN X innervates the soft palate, pharyngeal constrictors, and nearly all intrinsic laryngeal muscles. Damage can impair velopharyngeal closure, pharyngeal transit, AND vocal fold closure/airway protection at the same time - the widest functional impact of any cranial nerve tested.

Question 10

Cranial nerve XII (hypoglossal) - what speech/swallow functions does it control?

Accepted Answer

Tongue movement and protrusion. Unilateral damage causes the tongue to deviate toward the weak side on protrusion; bilateral damage severely limits articulation and bolus manipulation.

Question 11

A client has a communication disorder with no identifiable organic cause and onset tied to a stressful event. Which etiology category fits, and how does it differ from a structural/functional cause?

Accepted Answer

This is psychogenic - a functional disorder with no organic pathology, often stress- or anxiety-linked. It differs from structural/functional etiologies like cleft palate or velopharyngeal insufficiency, which involve an actual anatomical or physiological abnormality.

Question 12

What are the four core principles of the ASHA Code of Ethics?

Accepted Answer

Principle I: welfare of clients/persons served. Principle II: professional competence and honesty about one's credentials/qualifications. Principle III: honesty to the public. Principle IV: respect for colleagues and other professionals.

Question 13

An SLP is asked to treat a disorder outside their trained competence. Which ASHA ethics principle governs this, and what must they do?

Accepted Answer

Principle II (professional competence) requires clinicians to practice only within their demonstrated competence and to pursue additional training, supervision, or referral before treating outside that scope - misrepresenting competence is an ethics violation.

Question 14

A bilingual child mixes languages and shows errors in English that don't appear in their native language. Disorder or difference?

Accepted Answer

Difference, not disorder. A bilingual/multilingual profile alone is not evidence of a communication disorder - clinicians must compare performance across BOTH languages and use non-biased, culturally responsive measures before concluding impairment.

Question 15

A student speaks African American English (AAE) and a family member offers to interpret during a home-language assessment. What are the two practice traps here?

Accepted Answer

First, AAE is a rule-governed dialect, not a disorder - its patterns should not be scored as errors. Second, a trained interpreter must be used for language assessment; a family member (especially a child) is not an appropriate substitute and risks bias and role confusion.

Question 16

In public health terms, what is the difference between primary, secondary, and tertiary prevention in SLP practice?

Accepted Answer

Primary prevention stops a disorder before it starts (e.g., vocal hygiene education). Secondary prevention is early identification/screening to catch disorders early. Tertiary prevention reduces the impact of an existing, often chronic, disorder through treatment and compensation.

Question 17

For Medicare reimbursement, why does documentation need to show 'skilled' service rather than just continued treatment?

Accepted Answer

Payers only reimburse services requiring the skill, judgment, and expertise of a licensed SLP. Documentation must show ongoing clinical decision-making and measurable progress toward goals - treatment that has plateaued into pure maintenance (no skilled judgment needed) is typically not reimbursable.

Question 18

A student passes a hearing/vision check but fails a language screening. Should the SLP diagnose the disorder or refer for full assessment?

Accepted Answer

Refer for a full comprehensive assessment. Screening only yields a pass/fail/refer decision - it is not designed to produce a diagnosis or severity rating.

Question 19

What is the primary clinical purpose of a case history interview?

Accepted Answer

To gather prior developmental, medical, educational, and family history plus the client's/family's current concerns. This context shapes which standardized tools and hypotheses the clinician selects, rather than testing in a vacuum.

Question 20

What's the key difference between a standardized (norm-referenced) test and a criterion-referenced test?

Accepted Answer

A standardized test compares a client's performance to a norm group using standard scores/percentiles. A criterion-referenced test measures mastery of specific skills against a fixed standard, regardless of peer performance.

Question 21

What does dynamic assessment measure that a standardized test cannot?

Accepted Answer

Learning potential/modifiability - using a test-teach-retest format to see how much a client improves with cues and instruction. It's especially valuable for culturally/linguistically diverse clients where norm-referenced scores may be biased.

Question 22

Which standardized tool is the go-to single-word articulation/phonology measure?

Accepted Answer

The GFTA-3 (Goldman-Fristoe Test of Articulation, 3rd edition) - it assesses single-word speech sound production and phonological patterns.

Question 23

Which instrument quantifies stuttering severity, and what dimensions does it combine?

Accepted Answer

The SSI-4 (Stuttering Severity Instrument, 4th edition) combines frequency and duration of stuttering behaviors, plus physical concomitants, into an overall severity rating.

Question 24

Which tool is the standard perceptual rating scale for voice quality, and what does the acronym stand for?

Accepted Answer

The CAPE-V (Consensus Auditory-Perceptual Evaluation of Voice) - clinicians rate parameters like overall severity, roughness, breathiness, strain, pitch, and loudness on visual analog scales.

Question 25

A school-age child needs a comprehensive norm-referenced language test - which tool, and which one is used instead for infants/preschoolers?

Accepted Answer

CELF-5 (Clinical Evaluation of Language Fundamentals) is standard for school-age language testing. PLS-5 (Preschool Language Scales) covers birth through age 7, making it the choice for younger children.

Question 26

What does pure-tone audiometry measure, and why is it a mandatory step before diagnosing a speech/language disorder?

Accepted Answer

It measures hearing thresholds across frequencies. Undetected hearing loss can masquerade as (or worsen) a speech-sound or language disorder, so ruling out a sensory cause is a required early step.

Question 27

MBSS/VFSS vs FEES - what does each instrumental swallow study actually let you see?

Accepted Answer

MBSS/VFSS (videofluoroscopic swallow study) uses fluoroscopy to show the oral, pharyngeal, and esophageal phases in real time, including aspiration during the swallow itself. FEES (endoscopic) passes a scope through the nose to view the pharynx/larynx before and after the swallow, but the view 'whites out' during the swallow.

Question 28

A client has nonfluent, effortful speech but relatively preserved comprehension and poor repetition. Which aphasia type?

Accepted Answer

Broca's aphasia - nonfluent output, comprehension relatively spared, repetition impaired. Associated with damage to the inferior frontal gyrus (Broca's area).

Question 29

A client speaks fluently but the content is empty or paraphasic, comprehension is poor, and repetition is also poor. Which aphasia type?

Accepted Answer

Wernicke's aphasia - fluent but often meaningless speech, poor auditory comprehension, poor repetition. Associated with posterior superior temporal lobe (Wernicke's area) damage.

Question 30

A client is fluent with good comprehension, but repetition is disproportionately poor compared to everything else. Which aphasia type, and what tract is implicated?

Accepted Answer

Conduction aphasia - fluent speech, good comprehension, but repetition is the standout deficit. Classically linked to arcuate fasciculus damage disconnecting Wernicke's and Broca's areas.

Question 31

Global aphasia vs anomic aphasia - how do they sit at opposite ends of severity?

Accepted Answer

Global aphasia is the most severe: nonfluent output with poor comprehension AND poor repetition from widespread perisylvian damage. Anomic aphasia is the mildest: fluent speech with good comprehension and repetition, but a persistent word-finding (naming) deficit.

Question 32

A client's speech errors are inconsistent and worse on volitional speech than automatic speech, with visible groping for articulatory placement. Apraxia or dysarthria?

Accepted Answer

Apraxia of speech - a motor PLANNING/programming deficit, so errors are inconsistent and increase with utterance complexity or volitional demand. Dysarthria, by contrast, produces consistent errors from weak or incoordinated muscle EXECUTION.

Question 33

Match each dysarthria subtype to its hallmark: flaccid, spastic, ataxic, hypokinetic.

Accepted Answer

Flaccid = lower motor neuron damage, hypernasal/breathy voice. Spastic = bilateral upper motor neuron damage, strained-strangled voice. Ataxic = cerebellar damage, 'scanning' irregular speech. Hypokinetic = Parkinson's disease, reduced range of motion, monopitch/monoloudness.

Question 34

Aspiration vs penetration vs silent aspiration - what distinguishes each on an instrumental swallow study?

Accepted Answer

Aspiration: bolus passes below the vocal folds into the airway. Penetration: bolus enters the laryngeal vestibule but stays above the vocal folds (less severe). Silent aspiration: aspiration occurs with no cough or overt sign - it can only be caught on FEES/MBSS, not bedside observation.

Question 35

What does the SMART framework require of a well-written treatment goal?

Accepted Answer

Specific, Measurable, Achievable, Relevant, and Time-bound - a goal must state exactly what behavior, under what condition, to what criterion, and by when it will be met.

Question 36

Name four factors that most influence prognosis for therapy outcomes.

Accepted Answer

Severity of the disorder, client motivation/engagement, family/caregiver support, and presence of comorbid conditions. Mild severity, high motivation, strong support, and few comorbidities predict faster, more complete progress.

Question 37

Why must a clinician collect baseline data before starting treatment?

Accepted Answer

Baseline establishes the client's pre-treatment performance level on a target skill, giving an objective reference point to measure and document actual progress against - without it, 'improvement' can't be demonstrated.

Question 38

A child cannot produce /r/ spontaneously but produces it correctly with a model and visual cue. What does this 'stimulability' finding tell treatment planning?

Accepted Answer

Stimulability testing shows whether a sound can be elicited with cueing support, which directly informs target selection and prognosis - stimulable sounds often respond faster to traditional articulation therapy than sounds that can't be produced even with maximal cueing.

Question 39

In traditional articulation therapy, what is the typical treatment hierarchy from easiest to hardest?

Accepted Answer

Isolation, then syllable, then word, then phrase, then sentence, then conversation. Each level is mastered before moving up, gradually increasing linguistic and cognitive load on the target sound.

Question 40

A child has just 2-3 isolated sound errors - which phonological approach fits best, and why?

Accepted Answer

Minimal pairs therapy - it contrasts the error sound with the target sound in word pairs that differ by meaning (e.g., 'tea' vs 'key'), making the functional impact of the error salient. It suits children with a few isolated errors rather than widespread unintelligibility.

Question 41

A highly unintelligible child has multiple phonological patterns in error - which approach, and how does it structure targets?

Accepted Answer

The Cycles Approach - it rotates through multiple phonological patterns over short cycles without requiring mastery before moving on, gradually building the whole sound system rather than perfecting one pattern at a time.

Question 42

Stuttering modification vs fluency shaping - what does each approach target?

Accepted Answer

Stuttering modification reduces struggle and avoidance, teaching the client to ease into moments of stuttering rather than eliminate them. Fluency shaping rebuilds fluent speech patterns directly, using techniques like slowed rate, easy onsets, and continuous phonation.

Question 43

Why is LSVT LOUD specifically indicated for hypokinetic dysarthria from Parkinson's disease?

Accepted Answer

LSVT LOUD trains increased vocal loudness/effort as a single, high-intensity trigger that carries over into improved articulation, breath support, and intelligibility - directly targeting the reduced amplitude of movement characteristic of hypokinetic dysarthria.

Question 44

What makes milieu teaching a 'naturalistic' language intervention approach?

Accepted Answer

It embeds language targets into the child's everyday routines and motivation (play, requesting), using strategies like incidental teaching, the mand-model technique, and time delay - rather than isolated drill-based practice.

Question 45

Aided vs unaided AAC - and what specific aided system does PECS represent?

Accepted Answer

Unaided AAC uses only the body (sign, gesture); aided AAC uses an external tool (picture board, speech-generating device). PECS (Picture Exchange Communication System) is an aided AAC approach where the learner exchanges a picture for a desired item to build functional, initiated communication.

Question 46

A client aspirates thin liquids due to a delayed swallow trigger - which compensatory strategy fits, and why?

Accepted Answer

Chin tuck (chin-down posture) - it widens the vallecular space and narrows the airway entrance, buying time before the delayed trigger and reducing aspiration risk on that swallow.

Question 47

A client has reduced tongue-base retraction with pharyngeal residue, and separately a client has reduced laryngeal closure timing - which technique fits each?

Accepted Answer

Effortful swallow increases tongue-base-to-pharyngeal-wall pressure to clear residue. Mendelsohn maneuver prolongs laryngeal elevation, extending upper esophageal sphincter opening for clients with reduced laryngeal closure timing.

Question 48

A client has unilateral pharyngeal weakness, and separately any client has reduced airway-protection reaction time - which strategy fits each?

Accepted Answer

Head turn toward the weaker side redirects the bolus down the stronger, more functional side of the pharynx. Thickened liquids slow bolus flow, buying more reaction time for any client with reduced airway protection timing.

Question 49

What's the core distinction between a compensatory and a rehabilitative dysphagia strategy?

Accepted Answer

Compensatory strategies (postures, diet texture changes) produce an immediate safety fix but no lasting physiologic change once removed. Rehabilitative strategies (exercises, maneuvers) aim to build lasting strength/coordination that persists without the strategy in place.

Question 50

Generalization, maintenance, and dismissal - how do these three outcome concepts build on each other?

Accepted Answer

Generalization is the skill transferring to new, untrained contexts. Maintenance is the skill holding steady without ongoing clinician support. Dismissal follows once goals are met (or progress plateaus) and generalization/maintenance are documented - supported by ongoing progress-monitoring data, not just clinician impression.

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