Alliance for Accreditation and Certification of Dyslexia Specialists (AACDS) Certification Exam — Questions and Answers

Question 1: Which principle of biomedical ethics obligates a CDT therapist to act in the best interest of the student, even when that may conflict with institutional policies?

Beneficence (Correct answer)
Justice
Autonomy
Non-maleficence

Correct answer: Beneficence

Beneficence requires the practitioner to act in the patient's or student's best interest, prioritizing their welfare above institutional convenience.

Question 2: Which measure is MOST useful for monitoring the fluency component of reading progress in a student receiving dyslexia intervention?

Silent reading comprehension passage
Phoneme isolation task
Oral reading fluency probe (words correct per minute) (Correct answer)
Curriculum-embedded vocabulary quiz

Correct answer: Oral reading fluency probe (words correct per minute)

Oral reading fluency probes provide a reliable, sensitive index of reading automaticity and are widely used for progress monitoring.

Question 3: During a phoneme segmentation activity, a student taps each sound on their fingers while saying it aloud. What is the primary instructional purpose of finger-tapping?

To assess phonological awareness informally
To provide tactile-kinesthetic reinforcement of phoneme boundaries (Correct answer)
To develop fine motor skills
To replace written letter practice

Correct answer: To provide tactile-kinesthetic reinforcement of phoneme boundaries

Finger-tapping adds a tactile-kinesthetic channel that helps students physically represent and count discrete phonemes, strengthening auditory processing.

Question 4: The term 'specific language impairment' (SLI), now often called 'developmental language disorder' (DLD), differs from dyslexia primarily in that DLD involves:

Oral language deficits that precede and accompany literacy difficulties (Correct answer)
Exclusively phonological awareness deficits without grammar issues
A purely genetic etiology with no environmental contributors
Only reading deficits with intact oral language

Correct answer: Oral language deficits that precede and accompany literacy difficulties

DLD/SLI involves pervasive oral language deficits (grammar, vocabulary, narrative) that exist before formal literacy instruction, whereas dyslexia primarily manifests in written language with relatively stronger oral language.

Question 5: A CDT therapist in a public school is asked by an administrator to delay documenting a student's dyslexia diagnosis to avoid triggering special education obligations. What should the therapist do?

Refuse and document findings accurately, as falsifying or withholding records is unethical (Correct answer)
Document the diagnosis only in personal notes not accessible to the school
Ask the parents if they would prefer the delay
Comply, since administrators have authority over school employees

Correct answer: Refuse and document findings accurately, as falsifying or withholding records is unethical

Accurate documentation is an ethical and legal obligation; manipulating records to avoid legal responsibilities violates professional ethics and IDEA.

Question 6: A screener with high specificity but low sensitivity would be most likely to:

Miss many students who truly need intervention while rarely over-identifying students (Correct answer)
Have no impact on identification accuracy
Correctly identify most at-risk students but miss few non-at-risk students
Over-identify students who do not need intervention

Correct answer: Miss many students who truly need intervention while rarely over-identifying students

Low sensitivity means many true positives (at-risk students) are missed, while high specificity means few false positives (non-at-risk flagged as at-risk).

Question 7: Which learning disability is most often associated with dyslexia?

Attention deficit hyperactivity disorder (ADHD).
Dyscalculia (difficulty with math). (Correct answer)
Anxiety disorders.
Autism spectrum disorder.

Correct answer: Dyscalculia (difficulty with math).

Dyscalculia, a specific learning disability affecting mathematical abilities, is frequently co-occurring with dyslexia. While dyslexia primarily impacts reading and language, individuals often experience challenges in other academic areas, making dyscalculia a common comorbidity that requires separate but often integrated support.

Question 8: A CDT is monitoring a student's spelling progress as an indirect indicator of phonics and orthographic knowledge. Which measure would provide the most direct reflection of phonics application?

Administering a sight-word vocabulary test
Measuring reading comprehension on a passage-level assessment
Counting total words spelled correctly in a writing sample
Analyzing phoneme-grapheme correspondences in student spelling errors on a standardized spelling inventory (Correct answer)

Correct answer: Analyzing phoneme-grapheme correspondences in student spelling errors on a standardized spelling inventory

Error analysis on a spelling inventory reveals which phoneme-grapheme patterns a student has or has not mastered, directly informing phonics instruction.

Question 9: Which brain imaging finding is most consistently associated with dyslexia in neurological research?

Overactivation of the visual cortex
Reduced activation in left temporoparietal regions during reading (Correct answer)
Increased gray matter in the right frontal lobe
Enlarged corpus callosum

Correct answer: Reduced activation in left temporoparietal regions during reading

fMRI studies consistently show reduced activation in left temporoparietal areas (including the angular gyrus and Wernicke's area) in individuals with dyslexia during reading tasks.

Question 10: A parent reports that their child refuses to read at home despite therapy progress. The MOST helpful suggestion from the CDT is:

Force nightly reading to build discipline
Use high-interest decodable texts paired with positive reinforcement to reduce reading anxiety (Correct answer)
Recommend stopping therapy until the child is motivated
Advise the parent that home practice is optional

Correct answer: Use high-interest decodable texts paired with positive reinforcement to reduce reading anxiety

High-interest decodable texts lower anxiety while reinforcing skills, and positive reinforcement builds motivation for reading at home.

Question 11: When should a dyslexia therapist introduce cursive handwriting to a student who confuses print letters?

Early in treatment, as cursive eliminates many common letter reversals and supports kinesthetic learning (Correct answer)
Never—cursive is not recommended in structured literacy programs
Only at the request of the classroom teacher
Only after the student has mastered all 26 print letters

Correct answer: Early in treatment, as cursive eliminates many common letter reversals and supports kinesthetic learning

Cursive handwriting is often introduced early because its connected letterforms eliminate many reversal confusions (b/d, p/q) and reinforce kinesthetic letter memory.

Question 12: A CDT explains to a teacher that a student's letter reversals (b/d) are NOT a vision problem. Which neurological explanation is MOST accurate?

The student has an undiagnosed eye-tracking disorder
Letter reversals are caused by magnocellular pathway dysfunction in all cases
Reversals indicate the student skipped a developmental stage of crawling
The brain's orthographic memory has not yet formed stable, direction-specific representations for those graphemes (Correct answer)

Correct answer: The brain's orthographic memory has not yet formed stable, direction-specific representations for those graphemes

Letter reversals reflect incomplete orthographic memory formation, not vision problems; the brain has not yet established firm directional representations for similar-looking graphemes.

Question 13: According to Ehri's phases of word reading development, which phase is characterized by using some letter-sound knowledge but not the full alphabetic code?

Full alphabetic phase
Pre-alphabetic phase
Partial alphabetic phase (Correct answer)
Consolidated alphabetic phase

Correct answer: Partial alphabetic phase

In the partial alphabetic phase, children use some letter-sound cues (often initial and final consonants) but rely on partial phonetic cues rather than complete decoding.

Question 14: Which of the following is an example of a closed syllable?

cat (Correct answer)
bo-nus
ta-ble
stu-dent

Correct answer: cat

A closed syllable ends in a consonant and has a short vowel sound; 'cat' is a single closed syllable ending in the consonant 't'.

Question 15: When faced with a conflict of interest, what is the appropriate course of action?

Discuss it only if someone complains
Ignore the conflict if it seems minor
Disclose the conflict and recuse yourself from the situation (Correct answer)
Proceed as normal if it benefits the client

Correct answer: Disclose the conflict and recuse yourself from the situation

Disclosing conflicts of interest and recusing oneself ensures objective decision-making and maintains professional integrity.

Question 16: A student with dyslexia struggles most with reading pseudowords (nonsense words) compared to real words. This pattern primarily reflects a deficit in:

Semantic access to word meanings
Orthographic lexical memory for sight words
Visual scanning of text
Phonological decoding using grapheme-phoneme rules (Correct answer)

Correct answer: Phonological decoding using grapheme-phoneme rules

Pseudoword reading requires applying phonological decoding rules without any lexical support; poor pseudoword reading is a hallmark indicator of the phonological decoding deficit in dyslexia.

Question 17: In multisensory instruction, which three sensory pathways are most commonly engaged simultaneously?

Auditory, tactile-kinesthetic, and visual (Correct answer)
Olfactory, visual, and auditory
Tactile, proprioceptive, and gustatory
Visual, auditory, and gustatory

Correct answer: Auditory, tactile-kinesthetic, and visual

The VAK (visual-auditory-kinesthetic/tactile) triad is the foundation of multisensory literacy instruction to reinforce learning through multiple neural pathways.

Question 18: An evaluator observes that a student adds, omits, or substitutes sounds during oral reading. These error patterns are formally called:

Regressions
Fixations
Miscues (Correct answer)
Reversals

Correct answer: Miscues

Reading errors involving substitutions, omissions, or additions of sounds or words are technically referred to as miscues in reading assessment.

Question 19: When should a practitioner modify their assessment approach?

After completing all standard tests regardless of findings
Never, standardized protocols must always be followed exactly
Only when requested by the patient
When the patient presents with contraindications or special needs (Correct answer)

Correct answer: When the patient presents with contraindications or special needs

Assessment approaches should be modified when patients present with contraindications or special needs to ensure safety and obtain the most relevant diagnostic information.

Question 20: Which type of record would a CDT use to track the specific Orton-Gillingham lesson elements delivered each session?

Cumulative folder
Session plan log (Correct answer)
Standardized test protocol
Diagnostic eligibility report

Correct answer: Session plan log

A session plan log tracks the specific lesson elements, materials, and sequences delivered in each OG-based session.

Question 21: A CDT therapist accidentally emails a student's assessment report to the wrong address. What is the required action under HIPAA?

Inform only the school administrator, not the family
Document the incident privately and take no further action
Delete the sent email and hope the recipient ignores it
Notify the affected individual and the relevant authorities as required by breach notification rules (Correct answer)

Correct answer: Notify the affected individual and the relevant authorities as required by breach notification rules

HIPAA's Breach Notification Rule requires covered entities to notify affected individuals and, depending on scope, the HHS and media after an unsecured PHI breach.

Question 22: In the Orton-Gillingham lesson plan, the 'new learning' phase should:

Introduce only one new concept or phonogram to avoid cognitive overload (Correct answer)
Introduce 3-5 new phonograms to maximize each session
Always follow the student's interest rather than the scope and sequence
Be skipped on days the student shows fatigue or resistance

Correct answer: Introduce only one new concept or phonogram to avoid cognitive overload

OG methodology prescribes introducing only one new concept per lesson to maintain the incremental, mastery-based progression that defines structured literacy.

Question 23: Morphological awareness — understanding prefixes, roots, and suffixes — becomes increasingly important for reading development beginning at approximately which grade level?

Kindergarten through 1st grade
4th grade and beyond (Correct answer)
2nd through 3rd grade
Only in high school and college

Correct answer: 4th grade and beyond

From approximately 4th grade onward, academic vocabulary becomes heavily morphologically complex, making morphological awareness critical for reading comprehension and spelling of multisyllabic words.

Question 24: Which characteristic of English orthography makes it particularly challenging for students with dyslexia compared to more transparent orthographies?

English has an opaque, deep orthography with inconsistent grapheme-phoneme correspondences (Correct answer)
English words are longer on average than Spanish words
English has fewer morphemes than other languages
English lacks vowel markers unlike Semitic languages

Correct answer: English has an opaque, deep orthography with inconsistent grapheme-phoneme correspondences

English has a deep orthography where the same phoneme can be spelled multiple ways and the same spelling can represent different phonemes, increasing the phonological decoding burden.

Question 25: Which of the following background history factors is most relevant to include in a dyslexia assessment intake?

Dietary habits and sleep patterns
Family history of reading difficulties (Correct answer)
The student's preferred learning style
Extracurricular activity participation

Correct answer: Family history of reading difficulties

Dyslexia has a strong genetic component, and a family history of reading difficulties is a significant risk factor to document.

Question 26: A therapist uses magnetic letters to have a student build and manipulate words. This activity primarily targets:

Reading fluency and prosody
Phoneme-grapheme correspondence through kinesthetic encoding (Correct answer)
Sight word recognition via visual memory
Listening comprehension strategies

Correct answer: Phoneme-grapheme correspondence through kinesthetic encoding

Manipulating magnetic letters engages kinesthetic and visual channels to reinforce the link between sounds and their written symbols.

Question 27: A structured literacy therapist introduces spelling rules before reading rules for a particular pattern. What is the rationale?

Spelling assessments are easier to score than reading assessments
The IDA requires spelling be taught first in all certified programs
Encoding (spelling) demands more precise phoneme-grapheme knowledge, reinforcing decoding (Correct answer)
Spelling tasks are easier and build reading confidence faster

Correct answer: Encoding (spelling) demands more precise phoneme-grapheme knowledge, reinforcing decoding

Spelling requires the student to actively retrieve and apply the exact grapheme for each phoneme, which deepens and reinforces the phoneme-grapheme knowledge also used in decoding.

Question 28: A student using a pencil grip or adaptive writing tool returns it covered in saliva. How should the therapist handle this?

Wipe it with a dry cloth and place it in a drawer
Discard it after a single use
Rinse it with water and return it to the shared supply immediately
Clean and disinfect the tool before any other student uses it, or assign it permanently to that student (Correct answer)

Correct answer: Clean and disinfect the tool before any other student uses it, or assign it permanently to that student

Items contaminated with saliva must be cleaned and disinfected or dedicated to a single student to prevent transmission of pathogens.

Question 29: When administering the Comprehensive Test of Phonological Processing (CTOPP-2), which subtest measures the ability to delete individual phonemes from words?

Phoneme Elision (Correct answer)
Segmenting Words
Blending Words
Phoneme Isolation

Correct answer: Phoneme Elision

The Phoneme Elision subtest on the CTOPP-2 requires the student to say a word after removing a specified phoneme.

Question 30: A CDT wants to assess whether a student has made meaningful progress in phonemic awareness after 12 weeks of intervention. Which approach best demonstrates reliable growth?

Compare the student's score on a single post-test to a national norm
Show multiple progress monitoring data points collected across the intervention period with an upward trend (Correct answer)
Use only the student's end-of-year report card grade
Ask the classroom teacher for an informal rating of the student's reading

Correct answer: Show multiple progress monitoring data points collected across the intervention period with an upward trend

Multiple data points over time are far more reliable evidence of genuine growth than a single post-test comparison.

Question 31: A progress monitoring graph shows a student's data points consistently falling below the aim line over four consecutive probes. What action is indicated?

Discontinue intervention because it is not working
Adjust or intensify the intervention to better address the student's needs (Correct answer)
Celebrate the student's effort and maintain the same instructional approach
Continue the current intervention for another 8 weeks before deciding

Correct answer: Adjust or intensify the intervention to better address the student's needs

Data decision rules in progress monitoring specify that insufficient growth after several probes warrants modifying the intervention.

Question 32: A student with dyslexia writes 'wuz' for 'was' and 'sed' for 'said.' These phonetically plausible misspellings indicate which type of spelling knowledge?

No functional phonological awareness
Phonological spelling strategy with limited orthographic knowledge (Correct answer)
Visual memory-based whole-word spelling
Morphological spelling knowledge

Correct answer: Phonological spelling strategy with limited orthographic knowledge

Phonetically plausible errors show the student is applying phoneme-grapheme correspondences but lacks the orthographic pattern knowledge needed for conventional spelling.

Question 33: Which brain region is primarily associated with phonological processing deficits in individuals with dyslexia?

Cerebellum
Left temporoparietal cortex (Correct answer)
Right frontal lobe
Occipital lobe

Correct answer: Left temporoparietal cortex

Research consistently implicates the left temporoparietal cortex, particularly the angular gyrus region, in the phonological processing deficits characteristic of dyslexia.

Question 34: What should a practitioner do if a patient experiences an adverse reaction during treatment?

Stop the procedure immediately and assess the patient (Correct answer)
Complete the procedure and document afterward
Have the patient sign a waiver and continue
Continue at a reduced intensity

Correct answer: Stop the procedure immediately and assess the patient

Immediately stopping the procedure and assessing the patient is the correct response to an adverse reaction, prioritizing patient safety above all else.

Question 35: What is the best approach for teaching children with dyslexia to read?

Focusing only on auditory processing.
Using only visual aids.
Using speed-reading techniques.
Using a multisensory approach combining sight, sound, and touch. (Correct answer)

Correct answer: Using a multisensory approach combining sight, sound, and touch.

The most effective approach for teaching children with dyslexia is a multisensory one, which engages multiple senses simultaneously. By combining sight (seeing letters), sound (saying sounds), and touch/movement (tracing letters or using manipulatives), it creates stronger neural pathways for learning and retaining literacy skills, bypassing areas of weakness.

Question 36: A CDT therapist is reviewing a student's IEP and notices services that were promised but never delivered. What is the therapist's ethical responsibility?

Remove the undelivered services from the IEP to align it with reality
Document the gap and advocate for the student to receive the agreed-upon services (Correct answer)
Ignore it, as IEP compliance is the school's responsibility alone
Notify only the parents without involving the school team

Correct answer: Document the gap and advocate for the student to receive the agreed-upon services

Therapists have an ethical duty to advocate for students when promised services are not delivered, as this directly affects the student's right to a Free Appropriate Public Education (FAPE).

Question 37: Which of the following is an example of an informal assessment tool used in a dyslexia evaluation?

Woodcock-Johnson IV Letter-Word Identification
CTOPP-2 Phoneme Elision subtest
Informal Reading Inventory (IRI) (Correct answer)
GORT-5 Passage fluency score

Correct answer: Informal Reading Inventory (IRI)

Informal Reading Inventories are criterion-referenced, non-standardized tools used to determine independent, instructional, and frustration reading levels.

Question 38: What is the primary obligation of a certified professional regarding patient/client confidentiality?

Protect all personal information and disclose only with proper authorization (Correct answer)
Share information freely with other professionals
Disclose information when it benefits the practice
Keep records only if the patient requests it

Correct answer: Protect all personal information and disclose only with proper authorization

Protecting confidential information and disclosing only with proper authorization is a fundamental ethical and legal obligation of all certified professionals.

Question 39: A CDT administers the Test of Word Reading Efficiency (TOWRE-2). Which two subtests does this instrument include?

Word Attack and Word Identification
Oral Reading Accuracy and Reading Rate
Sight Word Efficiency and Phonemic Decoding Efficiency (Correct answer)
Letter-Word Identification and Passage Comprehension

Correct answer: Sight Word Efficiency and Phonemic Decoding Efficiency

The TOWRE-2 contains the Sight Word Efficiency subtest (real words) and the Phonemic Decoding Efficiency subtest (pseudowords).

Question 40: Dyscalculia that co-occurs with dyslexia is best described as which type of comorbidity?

Mutually exclusive condition
Comorbid condition sharing some neurological risk factors (Correct answer)
Coincidental overlap with no shared etiology
Secondary consequence caused exclusively by dyslexia

Correct answer: Comorbid condition sharing some neurological risk factors

Dyscalculia and dyslexia frequently co-occur and share some genetic and neurological risk factors, though they also have distinct etiological pathways.

Question 41: Which resource would be MOST valuable to share with a newly diagnosed family seeking peer support?

A list of expensive private tutors
A medical textbook on neurological disorders
Internal school district policies only
The International Dyslexia Association (IDA) parent resources and local branch contacts (Correct answer)

Correct answer: The International Dyslexia Association (IDA) parent resources and local branch contacts

The IDA offers evidence-based parent resources, fact sheets, and local branch connections that support newly diagnosed families.

Question 42: Which aspect of phonological processing involves the ability to hold and manipulate speech sounds in short-term memory?

Rapid automatized naming
Phoneme-grapheme correspondence
Phonological awareness
Phonological memory (verbal working memory) (Correct answer)

Correct answer: Phonological memory (verbal working memory)

Phonological memory refers to the ability to store phonological information in short-term/working memory and is one of three core components of phonological processing (along with PA and RAN).

Question 43: A CDT therapist learns that a student shared suicidal ideation during a session. What is the appropriate action?

Maintain confidentiality and document in records only
Wait to see if the student mentions it again before acting
Refer the student to a psychiatrist at the next scheduled appointment
Notify parents or guardians and appropriate crisis resources immediately (Correct answer)

Correct answer: Notify parents or guardians and appropriate crisis resources immediately

Disclosure of suicidal ideation triggers an exception to confidentiality; the therapist must notify guardians and connect the student with crisis resources immediately.

Question 44: A student exhibits slow reading speed but high accuracy. During assessment, this profile best warrants investigation into:

Reading fluency and automaticity (Correct answer)
Phoneme awareness deficits
Receptive vocabulary limitations
Decoding skill absence

Correct answer: Reading fluency and automaticity

Slow but accurate reading suggests a fluency deficit, where decoding is intact but not yet automatized.

Question 45: A dyslexia evaluator notices a student reads real words significantly better than nonsense words. This pattern most strongly suggests:

Reliance on sight word memory rather than decoding (Correct answer)
Intact phonemic awareness skills
Superior orthographic processing
A strength in phonological decoding

Correct answer: Reliance on sight word memory rather than decoding

A real-word advantage over pseudoword reading indicates the student relies on memorized word forms rather than phonological decoding skills.

Question 46: A second-grade student scores at the 12th percentile on a phonological awareness screener. Which next step is most appropriate for the CDT?

Immediately begin Tier 3 intensive intervention
Refer for a comprehensive psychoeducational evaluation only
Notify parents that the student has dyslexia
Conduct additional diagnostic assessment to confirm dyslexia risk and inform instruction (Correct answer)

Correct answer: Conduct additional diagnostic assessment to confirm dyslexia risk and inform instruction

Screener results indicating risk should prompt further diagnostic assessment rather than immediate labeling or skipping to the highest intervention tier.

Question 47: In literacy instruction, encoding refers to:

Using context clues to determine an unfamiliar word's meaning
Reading words quickly and accurately in connected text
Breaking a printed word into its component sounds for oral reading
Translating spoken sounds into written letters, i.e., spelling (Correct answer)

Correct answer: Translating spoken sounds into written letters, i.e., spelling

Encoding is the process of converting spoken language into written form (spelling), which is the reverse of decoding (reading printed words aloud).

Question 48: Neuroplasticity research in dyslexia intervention studies most commonly shows that effective reading instruction leads to:

Increased white matter volume in the corpus callosum only
Increased activation in left-hemisphere reading circuits and reduced compensatory right-hemisphere activity (Correct answer)
Growth of new neurons in the hippocampus only
Permanent reduction in left-hemisphere language areas

Correct answer: Increased activation in left-hemisphere reading circuits and reduced compensatory right-hemisphere activity

After effective reading intervention, neuroimaging studies show normalization of left-hemisphere reading network activation and reduction in the compensatory over-recruitment of right-hemisphere regions.

Question 49: How can teachers and parents collaborate during the screening and monitoring process?

By keeping separate records of the child's progress.
By only focusing on academic achievements.
By communicating regularly and adjusting strategies together. (Correct answer)
By allowing the child to choose their own interventions.

Correct answer: By communicating regularly and adjusting strategies together.

Effective collaboration between teachers and parents is vital during the screening and monitoring process for dyslexia. Regular communication ensures that both parties are aware of the child's progress, challenges, and successes, allowing them to align strategies, reinforce learning at home, and collectively advocate for the child's educational needs.

Question 50: What is the correct response to suspected equipment malfunction?

Continue using with adjusted settings
Wait for the next scheduled maintenance check
Remove from service immediately, tag as defective, and report to maintenance (Correct answer)
Let the next shift handle it

Correct answer: Remove from service immediately, tag as defective, and report to maintenance

Immediately removing malfunctioning equipment from service prevents potential harm and ensures only properly functioning equipment is used for professional services.

Question 51: What constitutes a boundary violation in professional practice?

Maintaining strict professional communication
Engaging in dual relationships that could impair professional judgment (Correct answer)
Following organizational policies
Attending continuing education events

Correct answer: Engaging in dual relationships that could impair professional judgment

Dual relationships that could impair professional judgment represent boundary violations, potentially compromising the quality and objectivity of professional services.

Question 52: During a parent meeting, a caregiver expresses guilt that their child's dyslexia is their fault. The CDT should FIRST:

Confirm that genetics does play a role to validate the concern
Acknowledge the emotion and then provide accurate information about the hereditary nature of dyslexia (Correct answer)
Dismiss the comment and redirect to the intervention plan
Refer the parent immediately to a psychologist

Correct answer: Acknowledge the emotion and then provide accurate information about the hereditary nature of dyslexia

Acknowledging the parent's emotion first builds trust, after which accurate psychoeducation can reduce guilt and increase engagement.

Question 53: Which of the following assessment domains is NOT typically included in a comprehensive dyslexia evaluation?

Gross motor coordination (Correct answer)
Reading fluency
Intelligence testing
Phonological processing

Correct answer: Gross motor coordination

While co-occurring motor issues may be noted, gross motor coordination is not a core domain assessed in a standard dyslexia evaluation.

Question 54: What should be done if a student is not making sufficient progress with the current intervention?

Move the student to a different subject.
Ignore the lack of progress.
Increase the intensity or modify the intervention strategies. (Correct answer)
Stop all interventions.

Correct answer: Increase the intensity or modify the intervention strategies.

If a student is not making sufficient progress with their current dyslexia intervention, it is critical to adjust the approach. This might involve increasing the intensity of the intervention, modifying specific strategies, or exploring different instructional methods to better meet the student's learning needs and ensure they receive effective support.

Question 55: Which of the following is a common strategy for teaching children with dyslexia?

Teaching through visual aids only.
Using multisensory learning techniques. (Correct answer)
Using group activities exclusively.
Only focusing on auditory processing.

Correct answer: Using multisensory learning techniques.

Multisensory learning techniques are highly effective for children with dyslexia because they engage multiple senses (visual, auditory, kinesthetic, tactile) simultaneously. This approach helps reinforce connections between sounds, symbols, and motor actions, which strengthens memory and understanding for individuals who struggle with traditional phonics instruction. Examples include tracing letters while saying their sounds or using manipulatives.

Question 56: Which of the following BEST describes a 'grapheme-phoneme correspondence card' drill used in OG instruction?

The therapist reads a sentence and the student selects a matching picture
The student sorts picture cards by initial phoneme into labeled bins
The student reads a word aloud and the therapist marks errors on a running record
The therapist shows a grapheme card and the student produces the corresponding sound(s) (Correct answer)

Correct answer: The therapist shows a grapheme card and the student produces the corresponding sound(s)

In a grapheme-phoneme card drill, seeing a written grapheme triggers the student to produce its sound, building automatic decoding pathways.

Question 57: How can parents support children with dyslexia at home?

By forcing the child to read at a fast pace.
By only focusing on math skills.
By providing extra reading practice and a positive environment. (Correct answer)
By discouraging reading practice.

Correct answer: By providing extra reading practice and a positive environment.

Parents play a vital role in supporting children with dyslexia by creating a positive and encouraging home environment. Providing consistent, extra reading practice, making reading enjoyable, and celebrating small successes helps build confidence and reinforces the skills learned in intervention, fostering a love for reading despite challenges.

Question 58: According to the IDA definition, which of the following is NOT a primary characteristic of dyslexia?

Difficulties with decoding
Difficulties with accurate word recognition
Difficulties with spelling
Difficulties with reading comprehension caused by poor listening comprehension (Correct answer)

Correct answer: Difficulties with reading comprehension caused by poor listening comprehension

The IDA definition specifies that reading comprehension difficulties in dyslexia result from deficits in phonological processing, not from poor listening/language comprehension (which would indicate a different profile).

Question 59: Which early literacy skill assessed in kindergarten screening is the STRONGEST predictor of later reading difficulties?

Letter-name knowledge alone
Listening vocabulary
Phoneme segmentation fluency (Correct answer)
Print concept awareness

Correct answer: Phoneme segmentation fluency

Phoneme segmentation fluency is one of the most robust early predictors of reading difficulties and future decoding ability.

Question 60: Which ethical obligation requires a dyslexia therapist to maintain accurate records of sessions, assessments, and interventions?

Veracity
Duty to warn
Accountability (Correct answer)
Fidelity

Correct answer: Accountability

Accountability requires practitioners to maintain transparent, accurate, and complete records that reflect the care provided.

Question 61: How does early intervention help children with dyslexia?

It only helps with handwriting.
It helps reduce reading difficulties and improves overall academic performance. (Correct answer)
It has no effect on school behavior.
It has little effect on long-term academic performance.

Correct answer: It helps reduce reading difficulties and improves overall academic performance.

Early intervention for dyslexia is crucial because it addresses reading difficulties before they become deeply entrenched. By providing targeted support early, children can develop foundational literacy skills, which significantly reduces long-term academic struggles and improves their overall educational outcomes and self-esteem.

Question 62: A CDT therapist is approached by a pharmaceutical company to endorse a supplement claimed to help dyslexia. What ethical principle is most relevant?

Justice
Fidelity
Veracity (Correct answer)
Non-maleficence

Correct answer: Veracity

Veracity obligates practitioners to be truthful and not endorse or promote treatments that lack scientific evidence, which could mislead families.

Question 63: Phoneme manipulation refers to:

Counting the number of syllables in a multisyllabic spoken word
Reading individual words in isolation versus reading them in connected text
Identifying rhyming word pairs within a spoken sentence
Deliberately adding, deleting, or substituting phonemes within spoken words (Correct answer)

Correct answer: Deliberately adding, deleting, or substituting phonemes within spoken words

Phoneme manipulation involves intentionally changing words by adding, deleting, or substituting phonemes and represents the highest, most demanding level of phonological awareness skill.

Question 64: The 'Wolf Naming Speed Deficit' refers to deficits in which cognitive process that is separate from phonological awareness?

Phoneme segmentation
Rapid automatized naming (RAN) (Correct answer)
Verbal working memory
Orthographic processing speed

Correct answer: Rapid automatized naming (RAN)

Maryanne Wolf's research identified rapid automatized naming (RAN) as a second core deficit in dyslexia, distinct from phonological awareness, leading to the double-deficit hypothesis.

Question 65: Research by Stanovich (1986) introduced the 'Matthew Effect' in reading, which means:

Early reading difficulties compound over time as poor readers read less and fall further behind (Correct answer)
Strong decoders eventually develop comprehension problems without vocabulary instruction
Students with dyslexia always catch up to peers with intensive intervention
Reading fluency is the best predictor of long-term academic success

Correct answer: Early reading difficulties compound over time as poor readers read less and fall further behind

The Matthew Effect describes how early reading failure leads to less reading practice, slower vocabulary growth, and widening achievement gaps compared to strong readers.

Question 66: Blending, as a phonological skill, is the process of:

Removing a sound from a word to form a new word
Combining individual phonemes together to pronounce a recognizable word (Correct answer)
Identifying the number of syllables in a spoken word
Breaking a spoken word into its individual sounds

Correct answer: Combining individual phonemes together to pronounce a recognizable word

Blending involves combining individual phonemes or word parts together in sequence to produce a recognizable spoken word.

Question 67: A parent requests that a CDT therapist withhold the student's dyslexia diagnosis from the student themselves. Ethically, how should the therapist respond?

Immediately disclose the diagnosis without consulting the parent
Refer the case to another therapist to avoid conflict
Comply fully with the parent's request
Share the diagnosis with the student in an age-appropriate manner after discussing with the parent (Correct answer)

Correct answer: Share the diagnosis with the student in an age-appropriate manner after discussing with the parent

The therapist should discuss the importance of age-appropriate disclosure with the parent, as withholding a diagnosis can harm the student's self-understanding and autonomy.

Question 68: An evaluator is comparing a student's listening comprehension to their reading comprehension. A significant gap where listening comprehension is much higher indicates:

A decoding deficit that limits access to text meaning (Correct answer)
Below-average intelligence affecting both modalities
A language processing disorder unrelated to dyslexia
A comprehension-based learning disability

Correct answer: A decoding deficit that limits access to text meaning

When listening comprehension far exceeds reading comprehension, it suggests the student understands language but cannot access text due to decoding difficulties.

Question 69: Which of the following is a hallmark characteristic of the written language of older students with dyslexia who have partially compensated for reading difficulties?

Use of simple vocabulary to avoid misspelling more complex words they know orally (Correct answer)
Complete absence of spelling errors in all written work
Inability to write any legible words without assistive technology
Consistently poor reading comprehension despite accurate decoding

Correct answer: Use of simple vocabulary to avoid misspelling more complex words they know orally

Compensated students often use simpler, safer vocabulary in writing to avoid misspelling multisyllabic words they know and use orally, masking their true language knowledge.

Question 70: The term 'phoneme manipulation' includes all of the following EXCEPT:

Phoneme identification in a printed word using color coding (Correct answer)
Phoneme substitution (change /b/ to /h/ in 'bat')
Phoneme blending (/k/-/æ/-/t/ → 'cat')
Phoneme deletion (remove /k/ from 'cat')

Correct answer: Phoneme identification in a printed word using color coding

Phoneme manipulation tasks are oral/auditory; color-coding printed phonemes is a print-based activity, not a phoneme manipulation task.

Question 71: A CDT is asked to evaluate whether a school's dyslexia screener is effective. Which psychometric property ensures the tool correctly identifies students who truly have dyslexia risk?

Specificity
Standard error of measurement
Reliability
Sensitivity (Correct answer)

Correct answer: Sensitivity

Sensitivity refers to a tool's ability to correctly identify true positives—students who actually have a reading risk or disability.

Question 72: What does 'informed consent' specifically require when enrolling a child in a dyslexia therapy program?

A written explanation of services, risks, benefits, and alternatives, signed by the guardian (Correct answer)
A signature from the child regardless of age
Verbal agreement from the child only
Approval from the school principal

Correct answer: A written explanation of services, risks, benefits, and alternatives, signed by the guardian

Informed consent requires that guardians receive a clear explanation of what therapy involves, its benefits and limitations, and alternatives, before signing.

Question 73: Which of the following best describes the prevalence of dyslexia in the general population according to current research?

Approximately 2–3% of the population
Exactly 1 in 100 individuals
Approximately 5–10% (some estimates up to 15–20% with milder profiles) (Correct answer)
Approximately 25–30% of all students

Correct answer: Approximately 5–10% (some estimates up to 15–20% with milder profiles)

Research estimates suggest 5–10% of the population has dyslexia severe enough to impact daily functioning, with some estimates reaching 15–20% when milder reading difficulties on the continuum are included.

Question 74: A student with dyslexia also shows significant difficulty with mental arithmetic and number fact retrieval. The evaluator should consider assessing for:

Dyscalculia as a co-occurring condition (Correct answer)
ADHD as the primary diagnosis
A global intellectual disability
Visual processing disorder only

Correct answer: Dyscalculia as a co-occurring condition

Dyscalculia frequently co-occurs with dyslexia and should be assessed when a student shows significant number processing or arithmetic fact difficulties alongside reading deficits.

Question 75: Digraphs are defined as:

Two vowels that blend together to form a single long vowel sound
Two letters — consonants or vowels — that together represent one phoneme (Correct answer)
Words that contain exactly two syllables
Two consecutive consonants that each retain their individual sounds

Correct answer: Two letters — consonants or vowels — that together represent one phoneme

Digraphs are two letters that together represent a single phoneme, such as 'sh,' 'ch,' 'th,' 'ph,' or the vowel digraph 'ea.'

Question 76: In a dyslexia therapy context, which of the following is an example of a physical safety hazard that should be corrected before a session?

A timer placed on a shelf
Pencils stored in a cup on the table
Electrical cords crossing a walking path between the door and the student's seat (Correct answer)
A student's reading materials placed on the desk

Correct answer: Electrical cords crossing a walking path between the door and the student's seat

Electrical cords across walkways are a trip hazard and must be secured or rerouted before a session begins.

Question 77: Which type of home activity MOST directly reinforces structured literacy instruction?

Playing word games that do not involve phoneme manipulation
Reading independently without any support
Watching educational TV programs about letters
Practicing phoneme-grapheme correspondence using letter tiles or sound boxes (Correct answer)

Correct answer: Practicing phoneme-grapheme correspondence using letter tiles or sound boxes

Letter tiles and sound boxes replicate the multisensory, phoneme-grapheme activities used in structured literacy sessions.

Question 78: Which finding from neuroimaging research BEST supports the effectiveness of Orton-Gillingham based interventions?

Post-intervention fMRI shows increased activation in left posterior reading systems, resembling typical readers (Correct answer)
Intervention has no measurable effect on brain activation patterns
Changes are seen only in the cerebellum after intervention
Intervention causes increased right-hemisphere compensatory activation only

Correct answer: Post-intervention fMRI shows increased activation in left posterior reading systems, resembling typical readers

Multiple fMRI studies demonstrate that effective structured literacy intervention produces increased left posterior activation, normalizing reading network function in students with dyslexia.

Question 79: Which patient right is protected under Section 504 of the Rehabilitation Act as it applies to students with dyslexia?

The right to a full-time personal aide
The right to transfer to any school of their choice
The right to reasonable accommodations in educational programs (Correct answer)
The right to free private tutoring

Correct answer: The right to reasonable accommodations in educational programs

Section 504 protects students with disabilities, including dyslexia, from discrimination and entitles them to reasonable accommodations in school programs.

Question 80: When scoring the Comprehensive Test of Phonological Processing-2 (CTOPP-2), a raw score of 14 on the Phoneme Elision subtest converts to a scaled score of 7. This means the student performed:

Within the average range
In the superior range
Below average for their age (Correct answer)
Above average for their age

Correct answer: Below average for their age

On the CTOPP-2, scaled scores use a mean of 10 and SD of 3; a scaled score of 7 falls one standard deviation below the mean, indicating below-average performance.

Question 81: What should a practitioner do when regulations conflict with employer policies?

Follow the regulation, as legal requirements supersede employer policies (Correct answer)
Follow whichever is easier to comply with
Always follow employer policies
Ignore both and use personal judgment

Correct answer: Follow the regulation, as legal requirements supersede employer policies

Legal and regulatory requirements always take precedence over employer policies, and practitioners have a professional obligation to comply with applicable laws.

Question 82: A 10-year-old with dyslexia reads at a 2nd-grade level despite average intelligence and adequate instruction. According to RTI frameworks, this student likely requires which level of intervention?

Tier 2 — small-group supplemental intervention
Tier 1 — differentiated core instruction only
Tier 3 — intensive individualized intervention (Correct answer)
No intervention until a formal psychoeducational evaluation is completed

Correct answer: Tier 3 — intensive individualized intervention

A student reading three or more years below grade level despite prior instruction meets criteria for Tier 3 intensive, individualized intervention within an RTI/MTSS framework.

Question 83: When documenting phoneme segmentation scores, a CDT notes '14/22 correct.' What does this notation style represent?

A grade equivalent score
A raw score expressed as items correct out of total items (Correct answer)
A standard score from a normed assessment
A percentage rounded to two decimals

Correct answer: A raw score expressed as items correct out of total items

Notation in the form 'correct/total' represents a raw score showing the number of correct responses out of the total items administered.

Question 84: Which feature of an error analysis is most informative when assessing a student's phonological decoding strategy?

Whether the errors are visually similar to the target word
Whether errors occur more in fiction versus nonfiction texts
Whether nonsense word errors are phonetically plausible (Correct answer)
Whether the student self-corrects after prompting

Correct answer: Whether nonsense word errors are phonetically plausible

Phonetically plausible nonsense word errors (e.g., reading 'bim' as 'beem') show the student is attempting to apply letter-sound rules rather than guessing.

Question 85: A CDT therapist is treating a student whose insurance company requests detailed session notes. What is the ethical concern with providing full session notes?

Insurance companies cannot legally receive any records
Providing notes would violate HIPAA in all circumstances
Full session notes may contain sensitive details beyond what is necessary for billing purposes (Correct answer)
Session notes are only relevant to the school, not insurers

Correct answer: Full session notes may contain sensitive details beyond what is necessary for billing purposes

The minimum necessary standard under HIPAA limits disclosure to only the information needed for the specific purpose, protecting student privacy.

Question 86: Which federal law requires schools to provide parents with information about their child's special education eligibility and services?

HIPAA
FERPA
IDEA (Individuals with Disabilities Education Act) (Correct answer)
ADA Title III

Correct answer: IDEA (Individuals with Disabilities Education Act)

IDEA mandates that parents be informed and involved in all eligibility, evaluation, and IEP decisions.

Question 87: Which of the following describes 'orthographic mapping,' as defined by David Kilpatrick?

The relationship between spelling patterns and reading rate
Mapping punctuation and formatting cues to reading fluency
The process by which phonemic awareness and letter-sound knowledge bond pronunciations to spellings in long-term memory (Correct answer)
The visual memorization of whole words through repeated exposure

Correct answer: The process by which phonemic awareness and letter-sound knowledge bond pronunciations to spellings in long-term memory

Orthographic mapping (Kilpatrick) is the mental process of using phonemic awareness and grapheme-phoneme knowledge to permanently store words' pronunciations, spellings, and meanings simultaneously in long-term memory.

Question 88: Which of the following is a key principle of structured literacy?

A sequential and explicit approach to skill development. (Correct answer)
Focusing on memorization.
Using only auditory materials.
Learning through natural context.

Correct answer: A sequential and explicit approach to skill development.

A key principle of structured literacy is its sequential and explicit approach to skill development. This means that foundational skills are taught in a logical order, building complexity gradually, and each concept is directly and clearly explained, leaving no room for guessing, which is essential for students with dyslexia to master literacy.

Question 89: Which of the following is an example of an effective intervention for students with dyslexia?

Memorization of high-frequency words.
Handwriting drills.
General spelling exercises.
Phonological awareness programs and reading interventions. (Correct answer)

Correct answer: Phonological awareness programs and reading interventions.

Effective interventions for students with dyslexia specifically target phonological awareness and provide structured reading instruction. Dyslexia is characterized by difficulties with phonological processing, so programs that build awareness of speech sounds and their corresponding letters are essential for developing decoding and encoding skills. These interventions are systematic, explicit, and often multisensory.

Question 90: What is the purpose of including a 'recommendations' section in a dyslexia evaluation report?

To assign blame for the student's reading difficulties
To predict the student's future academic achievement
To satisfy a legal requirement to list all available reading programs
To translate diagnostic findings into actionable, specific instructional and accommodation guidance (Correct answer)

Correct answer: To translate diagnostic findings into actionable, specific instructional and accommodation guidance

The recommendations section bridges diagnosis and practice by providing specific, actionable guidance for instruction, accommodations, and further assessment.

Question 91: A CDT uses colored tiles — one color for consonants and another for vowels — during phoneme manipulation tasks. This technique primarily supports:

Visual representation of phoneme identities and positions (Correct answer)
Morphological segmentation skills
Syllable stress and prosody awareness
Letter formation and handwriting automaticity

Correct answer: Visual representation of phoneme identities and positions

Color-coded tiles make abstract phoneme identities (consonant vs. vowel) and positions concrete and visually manipulable, supporting phonological awareness.

Question 92: A parent signs a release of information form allowing a CDT therapist to share records with a psychiatrist. Two years later, the psychiatrist's office requests updated records. Is the original release still valid?

No, releases typically expire and a new authorization is required (Correct answer)
No, only the student can authorize re-release as an adult
Yes, releases of information never expire
Yes, if the same diagnosis is involved

Correct answer: No, releases typically expire and a new authorization is required

Releases of information generally have an expiration date, and a new signed authorization is required before disclosing additional records.

Question 93: How does a teacher decide on the most appropriate intervention for a student with dyslexia?

By choosing a generic reading program.
By using the same intervention for all students.
By assessing the student's needs and selecting a targeted intervention. (Correct answer)
By allowing the student to choose their own method.

Correct answer: By assessing the student's needs and selecting a targeted intervention.

A teacher decides on the most appropriate intervention by thoroughly assessing the student's specific strengths and weaknesses in reading and language. This assessment identifies the precise areas of difficulty, such as phonological processing or decoding, allowing for the selection of a highly targeted and effective intervention program. A one-size-fits-all approach is ineffective for the diverse needs of students with dyslexia.

Question 94: What is the primary characteristic of dyslexia?

Difficulty with motor skills.
Difficulty with word recognition and spelling. (Correct answer)
Difficulty with arithmetic.
Difficulty with comprehension.

Correct answer: Difficulty with word recognition and spelling.

Dyslexia is a specific learning disability characterized by difficulties with accurate and/or fluent word recognition, and by poor spelling and decoding abilities. These difficulties typically stem from a deficit in the phonological component of language, which is often unexpected in relation to other cognitive abilities. It is not primarily a visual problem or a general learning disability.

Question 95: When a CDT provides services to a minor client, informed consent must be obtained from:

The minor client only, if they are over age 12
The referring physician or psychologist
The parent or legal guardian, with assent from the minor when developmentally appropriate (Correct answer)
The school principal and the parents jointly

Correct answer: The parent or legal guardian, with assent from the minor when developmentally appropriate

Legal informed consent for minors must be obtained from a parent or legal guardian; obtaining the minor's assent (agreement) is also an ethical best practice when developmentally appropriate.

Question 96: Which deficit would MOST interfere with a student's ability to benefit from orthographic mapping?

Weak phonemic awareness and phonological processing (Correct answer)
Poor handwriting
Difficulty with narrative comprehension
Limited background knowledge in science

Correct answer: Weak phonemic awareness and phonological processing

Orthographic mapping requires intact phonological representations; weak phonemic awareness prevents the formation of stable phoneme-grapheme connections needed for sight word storage.

Question 97: When a therapist discovers that tactile letter manipulatives have sharp edges after being dropped, what is the correct response?

Remove the damaged pieces immediately and replace them before the next session (Correct answer)
Use masking tape over the sharp edges temporarily
Sand down the edges and continue using them in the same session
Return the pieces to the bin and note it in the session log for later

Correct answer: Remove the damaged pieces immediately and replace them before the next session

Sharp manipulatives pose a safety risk and should be removed from active use and replaced prior to the next session.

Question 98: What is an important factor in ensuring successful progress monitoring for dyslexia?

Evaluating progress based solely on test scores.
Focusing only on behavioral improvements.
Providing feedback only at the end of the year.
Giving consistent and timely feedback on progress. (Correct answer)

Correct answer: Giving consistent and timely feedback on progress.

Consistent and timely feedback on progress is an important factor in ensuring successful progress monitoring for dyslexia. Regular feedback helps students understand their strengths and areas for improvement, motivates them, and allows educators to make immediate instructional adjustments, ensuring the intervention remains targeted and effective.

Question 99: A CDT is asked to share a student's session notes with a classroom teacher who wants to better support the student. What safety and legal consideration applies?

Notes may be shared if the teacher promises confidentiality
Verbal summaries can be shared freely even if written records cannot
Notes may only be shared if covered by the student's existing consent or FERPA-compliant disclosure agreement (Correct answer)
Sharing is always permitted among school staff who work with the same student

Correct answer: Notes may only be shared if covered by the student's existing consent or FERPA-compliant disclosure agreement

FERPA governs the sharing of student educational records and requires appropriate consent or a legitimate educational interest exception before disclosure.

Question 100: Which of the following is an example of a Tier 1 universal screening tool commonly used to identify students at risk for dyslexia in US schools?

Gray Oral Reading Tests (GORT-5)
Woodcock-Johnson Tests of Achievement (WJ-IV)
DIBELS Next (Dynamic Indicators of Basic Early Literacy Skills) (Correct answer)
Wechsler Individual Achievement Test (WIAT-III)

Correct answer: DIBELS Next (Dynamic Indicators of Basic Early Literacy Skills)

DIBELS Next is a widely used universal screener that provides brief, repeatable measures of early literacy skills for school-wide administration.

Question 101: What is the purpose of progress monitoring in dyslexia intervention?

To track attendance.
To collect personal data.
To assess whether the child is making progress with the intervention. (Correct answer)
To determine if the child needs to be tested again.

Correct answer: To assess whether the child is making progress with the intervention.

Progress monitoring in dyslexia intervention is essential for evaluating the effectiveness of the strategies being used. It provides ongoing data to determine if a child is responding to the intervention, making adequate progress, and if adjustments to the instructional approach or intensity are needed to ensure optimal learning.

Question 102: The Term 'curriculum-based measurement' (CBM) in the context of reading progress monitoring refers to:

Teacher-created rubrics for evaluating writing quality
Brief, standardized, repeated probes drawn from the curriculum used to gauge rate of improvement (Correct answer)
Assessments embedded in a specific commercial reading program's chapter tests
Annual state achievement tests aligned to grade-level standards

Correct answer: Brief, standardized, repeated probes drawn from the curriculum used to gauge rate of improvement

CBMs are brief, standardized, repeatable probes designed to measure student growth in the curriculum over time, widely used in RTI/MTSS frameworks.

Question 103: In the context of language-based learning disabilities, which term refers to a significant discrepancy between oral language comprehension and reading comprehension with intact decoding?

Hyperlexia
Specific language impairment
Developmental language disorder with dyslexia
Language comprehension deficit (poor comprehender profile) (Correct answer)

Correct answer: Language comprehension deficit (poor comprehender profile)

Poor comprehenders decode accurately but fail to understand text because of underlying language comprehension deficits, representing a distinct profile from dyslexia.

Question 104: How should a professional handle a situation where they lack competence?

Refer the client to a qualified professional or seek additional training (Correct answer)
Attempt the work and learn from mistakes
Accept the work to avoid losing the client
Delegate to an unlicensed assistant

Correct answer: Refer the client to a qualified professional or seek additional training

Referring to qualified professionals or obtaining additional training when facing competence limitations protects clients and upholds professional standards.

Question 105: Simultaneous Oral Spelling (SOS) requires the student to:

Highlight phonemes in a printed word before spelling it
Copy a word three times while the therapist reads it aloud
Read a word, spell it aloud, then write it while saying each letter name (Correct answer)
Sound out a word using only auditory cues without visual support

Correct answer: Read a word, spell it aloud, then write it while saying each letter name

SOS integrates auditory, kinesthetic, and visual channels: the student hears the word, articulates each letter, and writes simultaneously.

Question 106: What must be completed before using any specialized equipment?

Check only if the equipment looks damaged
Read the manual only during first use
Verify proper calibration and review safety procedures (Correct answer)
Turn it on and begin operation immediately

Correct answer: Verify proper calibration and review safety procedures

Verifying calibration and reviewing safety procedures before each use ensures accurate results and prevents equipment-related injuries or errors.

Question 107: A parent requests to add a statement of disagreement to their child's evaluation report. Under FERPA, the school must:

Destroy the original report and start fresh
Permit the parent to insert a written statement of disagreement into the record (Correct answer)
Reject the request and seal the original report
Rewrite the report to match the parent's perspective

Correct answer: Permit the parent to insert a written statement of disagreement into the record

FERPA allows parents to insert a statement of disagreement that becomes part of the official record when they believe the record is inaccurate.

Question 108: Working memory is critically important in reading because it allows a reader to:

Process punctuation and spacing automatically
Skip unfamiliar words and use context clues only
Hold decoded word parts in mind while blending them into a complete word (Correct answer)
Recognize whole words by sight without phonological processing

Correct answer: Hold decoded word parts in mind while blending them into a complete word

Working memory enables the reader to retain decoded phoneme segments while blending them, making it essential for sounding out unfamiliar words.

Question 109: Which concept describes a patient's right to make decisions about their own care, including the right to refuse services?

Non-maleficence
Beneficence
Justice
Autonomy (Correct answer)

Correct answer: Autonomy

Autonomy is the ethical principle that upholds a person's right to self-determination, including the right to accept or refuse interventions.

Question 110: Which term describes the phenomenon where a child with dyslexia reads words correctly but very slowly and with great effort?

Orthographic mapping failure
Compensated dyslexia
Hyperlexia
Dysfluent decoding (Correct answer)

Correct answer: Dysfluent decoding

Dysfluent decoding refers to accurate but labored, slow word reading that still reflects the core deficit in phonological processing even when accuracy improves.

Question 111: A CDT therapist realizes mid-treatment that a student's needs exceed their competence level. What is the ethical obligation?

Refer the student to a more qualified professional and transition care appropriately (Correct answer)
Continue treating while independently studying the relevant area
Consult online resources and continue without disclosing the limitation
Discharge the student without providing a referral

Correct answer: Refer the student to a more qualified professional and transition care appropriately

Practicing within one's competence is a core ethical obligation; when a case exceeds a therapist's skills, referral and proper transition of care are required.

Question 112: Which morpheme is a free morpheme that can stand alone as a word?

-ing (as a suffix)
-tion
un- (as a prefix)
play (Correct answer)

Correct answer: play

A free morpheme is a meaningful unit that can stand alone; 'play' is a base word that functions independently.

Question 113: A parent asks if their child should receive a diagnosis of dyslexia from a physician before starting intervention. The CDT should explain:

The school must complete genetic testing before services are provided
Intervention can and should begin based on assessment data; a medical diagnosis is not required to start services (Correct answer)
A medical diagnosis is required before any intervention can begin
Only neurologists can authorize dyslexia intervention

Correct answer: Intervention can and should begin based on assessment data; a medical diagnosis is not required to start services

Evidence-based intervention should begin as soon as assessment data indicates a need; waiting for a medical diagnosis delays critical early support.

Question 114: Which of the following best describes the ethical concept of 'do no harm' in the context of dyslexia therapy?

Non-maleficence (Correct answer)
Beneficence
Fidelity
Autonomy

Correct answer: Non-maleficence

Non-maleficence is the principle that practitioners should avoid causing harm, whether physical, emotional, or psychological, to those they serve.

Question 115: A student who is an English Language Learner (ELL) performs poorly on a phonological awareness screener administered in English. What should the CDT consider?

The student should automatically receive Tier 3 intervention
Results may reflect limited English proficiency rather than phonological processing deficits, and screening in L1 is recommended when possible (Correct answer)
ELL students cannot be screened for dyslexia risk until they are fully English proficient
Phonological awareness skills are language-neutral and ELL status is irrelevant

Correct answer: Results may reflect limited English proficiency rather than phonological processing deficits, and screening in L1 is recommended when possible

Phonological awareness can be assessed in a student's first language to distinguish language acquisition differences from true phonological processing deficits.

Question 116: The 'phonological core deficit' model of dyslexia was most prominently developed and supported by which researcher?

Sally Shaywitz
Keith Stanovich
Maryanne Wolf
Frank Vellutino (Correct answer)

Correct answer: Frank Vellutino

Frank Vellutino's research in the 1970s–1990s was foundational in establishing that phonological (not visual) processing deficits are the core cause of dyslexia.

Question 117: What is the primary purpose of conducting a comprehensive patient assessment in Certified Dental Technicians practice?

To reduce the length of treatment sessions
To fulfill insurance documentation requirements
To establish baseline measurements and identify treatment needs (Correct answer)
To minimize staff workload

Correct answer: To establish baseline measurements and identify treatment needs

Comprehensive patient assessment establishes baseline measurements and identifies specific treatment needs, forming the foundation for effective care planning.

Question 118: During an initial evaluation, what should be documented first?

Billing codes and insurance information
Treatment plan and expected outcomes
Discharge planning details
Patient demographics and chief complaint (Correct answer)

Correct answer: Patient demographics and chief complaint

Patient demographics and chief complaint are documented first to establish identity and the primary reason for seeking care, guiding all subsequent assessment activities.

Question 119: When a student's progress monitoring data shows high variability (zigzag pattern) around the aim line, the CDT should FIRST:

Average the data points and make a decision based on the average alone
Immediately change the intervention program
Examine whether the probes are being administered and scored consistently, and look for sources of variability (Correct answer)
Assume the student is not responding to intervention and refer for evaluation

Correct answer: Examine whether the probes are being administered and scored consistently, and look for sources of variability

High variability often reflects inconsistent administration conditions or other external factors, which must be ruled out before changing the intervention.

Question 120: When is it MOST appropriate for a CDT to refer a family to a private educational advocate?

When the family speaks a language other than English
When the child shows rapid progress and no longer needs services
When parents want to understand their child's IEP rights and the school district is unresponsive (Correct answer)
When the therapist disagrees with the parents' goals

Correct answer: When parents want to understand their child's IEP rights and the school district is unresponsive

An educational advocate helps families navigate IEP processes and advocate for appropriate services when the school district is unresponsive.

Question 121: Which phonological awareness skill is typically assessed first when evaluating a student suspected of dyslexia?

Syllable blending
Phoneme segmentation
Rhyme recognition (Correct answer)
Phoneme manipulation

Correct answer: Rhyme recognition

Rhyme recognition is an early-developing phonological awareness skill assessed before more complex tasks like phoneme segmentation.

Question 122: Which brain imaging technique measures changes in blood oxygenation levels (BOLD signal) to infer neural activity and is widely used in dyslexia research?

DTI (diffusion tensor imaging)
fMRI (functional magnetic resonance imaging) (Correct answer)
EEG (electroencephalography)
PET (positron emission tomography)

Correct answer: fMRI (functional magnetic resonance imaging)

fMRI measures the BOLD (blood-oxygen-level-dependent) signal, which reflects local increases in oxygenated blood flow that accompany neural activity, making it the standard neuroimaging tool in dyslexia research.

Question 123: Which document formalizes the goals, services, and accommodations agreed upon by the school team and parents for a student with dyslexia?

Psychoeducational evaluation
504 Plan only
IEP (Individualized Education Program) (Correct answer)
Progress monitoring report

Correct answer: IEP (Individualized Education Program)

The IEP is the legally binding document that outlines specific goals, services, accommodations, and parent consent under IDEA.

Question 124: The Elkonin boxes technique is PRIMARILY used to develop:

Vocabulary through semantic mapping
Sight word automaticity through repetition
Reading fluency and expression
Phoneme segmentation by mapping sounds to boxes (Correct answer)

Correct answer: Phoneme segmentation by mapping sounds to boxes

Elkonin (sound) boxes provide a concrete visual scaffold where students push a token into a box for each phoneme they hear, supporting segmentation.

Question 125: When interpreting a discrepancy model for dyslexia identification, which comparison is the evaluator examining?

Phonological awareness versus orthographic processing
Decoding accuracy versus reading fluency
IQ score versus reading achievement score (Correct answer)
Listening comprehension versus reading comprehension

Correct answer: IQ score versus reading achievement score

The IQ-achievement discrepancy model compares a student's intellectual ability to their reading achievement to identify unexpected underperformance.

Question 126: Which research finding best supports structured literacy instruction over whole-language approaches for students with dyslexia?

Balanced literacy produces equivalent outcomes to structured literacy for at-risk students
Context clues are more effective than decoding for unknown word identification in dyslexia
The National Reading Panel (2000) found strong evidence for explicit, systematic phonics instruction (Correct answer)
Whole-language improves reading motivation more than phonics-based approaches

Correct answer: The National Reading Panel (2000) found strong evidence for explicit, systematic phonics instruction

The National Reading Panel's 2000 report found strong scientific evidence that systematic, explicit phonics instruction is essential for all readers and especially critical for students with dyslexia.

Question 127: Which of the following best distinguishes dyslexia from an intellectual disability when reading difficulties are present?

Students with dyslexia always have higher verbal IQ scores than performance IQ scores
Intellectual disability never co-occurs with dyslexia
Dyslexia is characterized by unexpected reading difficulty relative to overall cognitive ability and adequate instruction (Correct answer)
Students with dyslexia perform at grade level in all non-reading academic areas

Correct answer: Dyslexia is characterized by unexpected reading difficulty relative to overall cognitive ability and adequate instruction

The defining feature of dyslexia is unexpected reading difficulty—the reading deficit is disproportionate to the student's overall cognitive ability and cannot be explained by intellectual disability alone.

Question 128: Which of the following best describes the role of the prefrontal cortex in reading difficulties?

It supports executive functions like working memory and cognitive control that compensate for decoding deficits (Correct answer)
It regulates eye movement saccades during text reading
It stores the phonological representations of individual words
It directly performs grapheme-phoneme conversion

Correct answer: It supports executive functions like working memory and cognitive control that compensate for decoding deficits

The prefrontal cortex supports executive functions including working memory, attention, and cognitive control; individuals with dyslexia often recruit it more heavily as a compensatory strategy during reading.

Question 129: Which waste should be placed in biohazard containers?

All waste generated in clinical areas
Paper and packaging materials
Only sharps and needles
Items contaminated with blood or potentially infectious materials (Correct answer)

Correct answer: Items contaminated with blood or potentially infectious materials

Biohazard containers are specifically for items contaminated with blood or other potentially infectious materials, following OSHA bloodborne pathogen standards.

Question 130: Under HIPAA's Privacy Rule, which of the following is a permitted disclosure without patient authorization?

Providing records to a research team without an IRB waiver
Sharing records with a student's employer upon request
Releasing records to a friend of the family for convenience
Disclosing records to public health authorities for disease reporting (Correct answer)

Correct answer: Disclosing records to public health authorities for disease reporting

HIPAA permits disclosure to public health authorities for legally authorized purposes such as disease reporting without requiring patient authorization.

Question 131: What is the best practice for documenting assessment findings?

Only document abnormal findings
Use subjective descriptions without measurements
Wait until the end of the day to document from memory
Record findings objectively using measurable criteria immediately after assessment (Correct answer)

Correct answer: Record findings objectively using measurable criteria immediately after assessment

Documenting findings objectively with measurable criteria immediately after assessment ensures accuracy, provides legal protection, and creates reliable baseline data for tracking progress.

Question 132: Which of the following would be MOST appropriate to include in a progress monitoring report shared with parents of a student receiving dyslexia intervention?

Raw score data only, without context or explanation
Percentile ranks from the initial eligibility evaluation only
A graph showing the student's growth over time compared to the aim line, with plain-language explanation (Correct answer)
Detailed psychometric reliability coefficients of the assessment tool

Correct answer: A graph showing the student's growth over time compared to the aim line, with plain-language explanation

Graphs with plain-language explanations make progress data accessible to parents and support collaborative decision-making.

Question 133: Which federal law explicitly requires schools to use 'objective criteria' including 'a pattern of strengths and weaknesses' when identifying students with specific learning disabilities?

Americans with Disabilities Act (ADA)
Section 504 of the Rehabilitation Act
Every Student Succeeds Act (ESSA)
Individuals with Disabilities Education Act (IDEA) 2004 (Correct answer)

Correct answer: Individuals with Disabilities Education Act (IDEA) 2004

IDEA 2004 allows states to use either RTI data or a pattern of strengths and weaknesses approach (alongside other criteria) to identify students with specific learning disabilities including dyslexia.

Question 134: A CDT selects decodable texts for a student practicing CVC words. Decodable texts are appropriate because:

They contain words controlled to match the student's current phonics knowledge (Correct answer)
They require no teacher support once the student can read independently
They are shorter than leveled readers and easier to finish
They use rich vocabulary to build background knowledge

Correct answer: They contain words controlled to match the student's current phonics knowledge

Decodable texts are carefully controlled so nearly all words can be decoded using phonics patterns the student has already been taught.

Question 135: When documenting a student's oral reading rate, a CDT should record which unit of measurement?

Words per minute (WPM) (Correct answer)
Syllables per sentence
Reading levels per month
Errors per paragraph

Correct answer: Words per minute (WPM)

Oral reading fluency is standardly measured in words per minute (WPM), which allows comparison to grade-level norms.

Question 136: A CDT wants to set realistic expectations with a parent about intervention timelines. Which statement is MOST accurate?

Most students with dyslexia are remediated within 6 weeks
Dyslexia cannot improve with intervention
Significant gains in decoding typically require at least 1–2 years of consistent structured literacy intervention (Correct answer)
Gains depend entirely on IQ and are unpredictable

Correct answer: Significant gains in decoding typically require at least 1–2 years of consistent structured literacy intervention

Research consistently shows that meaningful decoding improvements require sustained, intensive structured literacy intervention over one to two years.

Question 137: When a CDT writes an IEP goal stating 'the student will decode CVC words with 90% accuracy in 3 of 4 trials,' the '3 of 4 trials' criterion indicates:

The consistency criterion needed to demonstrate mastery (Correct answer)
The number of errors permitted across the year
The number of weekly sessions scheduled
The total number of words presented per lesson

Correct answer: The consistency criterion needed to demonstrate mastery

A consistency criterion (e.g., 3 of 4 trials) specifies how reliably the skill must be demonstrated to count as mastered.

Question 138: When interpreting a student's score on the KTEA-3 Word Recognition subtest for screening purposes, which score type is MOST useful for comparing the student to same-age peers?

Standard score (Correct answer)
Raw score
Grade equivalent
Age equivalent

Correct answer: Standard score

Standard scores (mean 100, SD 15) allow direct comparison to a normative same-age peer group and are the most interpretable for screening decision-making.

Question 139: A student scores significantly below average on the Spelling subtest of the Wechsler Individual Achievement Test (WIAT-4). This finding supports a dyslexia profile because:

Dyslexia affects phonological encoding, which underlies both reading and spelling (Correct answer)
Spelling deficits replace the need to assess decoding
Spelling is assessed only for eligibility, not diagnosis
Poor spelling always indicates a writing disorder rather than dyslexia

Correct answer: Dyslexia affects phonological encoding, which underlies both reading and spelling

Dyslexia affects the phonological system, causing difficulty encoding sounds into letters in spelling just as in decoding letters to sounds in reading.

Question 140: What is the role of the thalamus in phonological processing?

It is the primary site of grapheme storage
It generates the rhythm of speech production
It suppresses non-linguistic auditory input during reading
It acts as a relay station for sensory signals, including auditory information, on the way to cortex (Correct answer)

Correct answer: It acts as a relay station for sensory signals, including auditory information, on the way to cortex

The thalamus serves as the brain's relay station, routing auditory information from the brainstem (via the medial geniculate nucleus) to the auditory cortex for higher processing.

Question 141: Which type of colored overlay maintenance practice helps ensure consistent visual benefit for a student using them during reading?

Cleaning them weekly with a dry lint-free cloth and storing them flat (Correct answer)
Replacing them after every session
Laminating new ones each month
Washing them with soap and water daily

Correct answer: Cleaning them weekly with a dry lint-free cloth and storing them flat

Weekly cleaning with a dry lint-free cloth removes smudges without damaging the overlay, and flat storage prevents warping.

Question 142: Which condition is characterized by significant difficulty with written expression, including handwriting, spelling, and written composition, often co-occurring with dyslexia?

Dyspraxia
Developmental coordination disorder
Dyscalculia
Dysgraphia (Correct answer)

Correct answer: Dysgraphia

Dysgraphia specifically affects written expression and often co-occurs with dyslexia since both involve language-based processing, though dysgraphia also has a motor component.

Question 143: Which part of the inner ear contains the hair cells responsible for transducing sound waves into neural signals?

Utricle
Semicircular canals
Eustachian tube
Cochlea (Correct answer)

Correct answer: Cochlea

The cochlea contains hair cells (inner and outer) that convert mechanical vibrations from sound waves into electrical neural signals transmitted via the auditory nerve.

Question 144: A school employs a CDT therapist to assess students for dyslexia. A parent requests a copy of their child's evaluation report. Under IDEA, what must the school provide?

Access within 90 days after the initial request
Access to the full evaluation report at no cost to the parent (Correct answer)
A summary of results only, not the full report
Access only if the parent hires an independent advocate

Correct answer: Access to the full evaluation report at no cost to the parent

Under IDEA, parents have the right to access all education records, including evaluation reports, free of charge.

Question 145: A dyslexia therapist records a student reading 'horse' as 'house'. This error is MOST likely due to:

Auditory processing disorder affecting vowel discrimination
Visual similarity between 'orse' and 'ouse' leading to a visual guess (Correct answer)
Working memory overload causing full word omission
Poor phonological awareness of individual phonemes

Correct answer: Visual similarity between 'orse' and 'ouse' leading to a visual guess

Substituting 'house' for 'horse' reflects using visual features of the first letter and word length to guess rather than fully decoding all phonemes.

Question 146: Orthographic mapping refers to the process by which readers:

Form permanent memory representations of words by connecting phonemes, graphemes, and meaning (Correct answer)
Memorize whole-word shapes through repeated visual exposure
Copy words from the board to build muscle memory
Use context clues to predict the next word in a sentence

Correct answer: Form permanent memory representations of words by connecting phonemes, graphemes, and meaning

Orthographic mapping, described by Kilpatrick, is the mental process of permanently connecting a word's pronunciation, spelling, and meaning into long-term memory.

Question 147: When graphing a student's CBM (Curriculum-Based Measurement) scores, what does the 'aimline' represent?

The student's historical lowest score
The projected rate of progress needed to reach the goal by the deadline (Correct answer)
The therapist's subjective expectation for the session
The class average benchmark score

Correct answer: The projected rate of progress needed to reach the goal by the deadline

The aimline is a drawn line from the student's baseline score to the goal score at the goal date, showing the expected growth trajectory.

Question 148: A therapist is using curriculum-based measurement (CBM) as part of a dyslexia evaluation. CBM data is best used to:

Assess phonological awareness in isolation
Replace standardized norm-referenced tests
Monitor response to intervention over time (Correct answer)
Determine eligibility for a formal dyslexia diagnosis

Correct answer: Monitor response to intervention over time

CBM is a formative assessment tool designed to track student progress and response to instruction over repeated administrations.

Question 149: During a phoneme segmentation activity using a digital whiteboard, the stylus loses pressure sensitivity. Which is the most appropriate immediate action?

End the session early and reschedule
Have the student use a mouse instead of the stylus for all future sessions
Continue the activity using finger touch as a substitute
Pause the activity, check stylus battery and Bluetooth pairing, then resume when resolved (Correct answer)

Correct answer: Pause the activity, check stylus battery and Bluetooth pairing, then resume when resolved

Checking the stylus battery and Bluetooth connection resolves the most common causes of pressure sensitivity failure quickly.

Question 150: When teaching the concept of 'closed syllable,' a structured literacy teacher would MOST likely explain it as:

A syllable containing a vowel team that produces one sound
A syllable ending in a vowel that makes a long sound
A syllable that ends in one or more consonants and contains a short vowel (Correct answer)
A syllable with a silent 'e' that lengthens the preceding vowel

Correct answer: A syllable that ends in one or more consonants and contains a short vowel

A closed syllable is defined by its ending consonant(s) which 'close' the vowel, causing it to produce its short sound.

Question 151: What is the key factor in distinguishing dyslexia from other learning disabilities?

It causes difficulties in all academic subjects equally.
It affects only mathematical skills.
It only affects social interaction.
It specifically affects reading, spelling, and decoding abilities. (Correct answer)

Correct answer: It specifically affects reading, spelling, and decoding abilities.

Dyslexia is specifically characterized by difficulties with accurate and/or fluent word recognition, poor decoding, and poor spelling abilities. While it can impact other academic areas indirectly, its core definition and distinguishing feature lie in these specific challenges related to language processing and literacy, differentiating it from other learning disabilities like dyscalculia or ADHD.

Alliance for Accreditation and Certification of Dyslexia Specialists (AACDS) Certification Exam

This exam certifies individuals as competent Dyslexia Therapists, demonstrating expertise in multisensory structured language education for individuals with dyslexia.

150

Questions

180 min

Time Limit

70%

To Pass

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