SLP Social and Cognitive Communication 2 — Questions and Answers
Question 1: A 10-year-old with TBI struggles to understand sarcasm and jokes. Which cognitive-communication domain is primarily impaired?
- Working memory
- Theory of mind and pragmatic inference (Correct answer)
- Phonological processing
- Syntax comprehension
Correct answer: Theory of mind and pragmatic inference
Understanding sarcasm and humor requires theory of mind — inferring the speaker's intended meaning differs from literal words — a core pragmatic skill often impaired after TBI.
Question 2: Which assessment tool is specifically designed to evaluate functional communication in adults with cognitive-communication disorders following brain injury?
- CELF-5
- ASHA FACS (Correct answer)
- GFTA-3
- PPVT-5
Correct answer: ASHA FACS
The ASHA Functional Assessment of Communication Skills (FACS) measures real-world communication performance across social, life-skill, communication of basic needs, and reading/writing domains.
Question 3: A patient with right hemisphere damage frequently goes off-topic during conversation. This is best described as impaired:
- Phonemic fluency
- Discourse coherence (Correct answer)
- Articulation precision
- Auditory discrimination
Correct answer: Discourse coherence
Maintaining topic relevance across a conversation requires discourse coherence, a macro-level language skill frequently disrupted by right hemisphere damage.
Question 4: Which of the following best describes 'cognitive flexibility' as it relates to social communication?
- The ability to produce grammatically complex sentences
- The capacity to shift attention and perspective during conversation (Correct answer)
- Speed of lexical retrieval under time pressure
- Accuracy of phoneme discrimination in noise
Correct answer: The capacity to shift attention and perspective during conversation
Cognitive flexibility allows speakers to adjust conversational strategies, take listener perspective, and shift topic focus — all essential for adaptive social communication.
Question 5: A child with autism spectrum disorder uses scripted phrases from TV shows in unrelated social contexts. This behavior is called:
- Echolalia (Correct answer)
- Perseveration
- Confabulation
- Jargon
Correct answer: Echolalia
Delayed echolalia involves reproducing previously heard utterances — often from media — in contexts where they may not be communicatively appropriate.
Question 6: When targeting social communication in a school-age child with language disorder, which context is MOST naturalistic and recommended?
- Flashcard drills in a quiet therapy room
- Peer interaction during structured group activities (Correct answer)
- 1:1 clinician-directed imitation tasks
- Computer-based matching exercises
Correct answer: Peer interaction during structured group activities
Naturalistic peer interaction during structured group activities provides authentic social communication opportunities and promotes generalization of skills.
Question 7: Executive function deficits after frontal lobe damage most commonly manifest in social communication as:
- Reduced vocal loudness
- Impulsive topic changes and poor self-monitoring (Correct answer)
- Decreased speech rate
- Loss of vocabulary
Correct answer: Impulsive topic changes and poor self-monitoring
The frontal lobes govern inhibition and self-monitoring; damage leads to impulsivity, disinhibited remarks, and poor awareness of conversational norms.
SLP Social and Cognitive Communication 2
A 10-year-old with TBI struggles to understand sarcasm and jokes.
Which cognitive-communication domain is primarily impaired?