The Big Nine clinical areas

Speech Sound ProductionArea 1 of 9

Speech Sound Production

Articulation, phonology, motor speech disorders, and apraxia of speech.

Developmental norms for speech sound acquisition, phonological processes (and when they should disappear), differential diagnosis of articulation vs phonological disorders vs childhood apraxia of speech, motor speech disorders in adults (dysarthria types and their lesion sites), and evidence-based treatment approaches for each.

Speech sound production is one of the highest-volume clinical knowledge areas in SLP exam prep. Expect questions that cross assessment, differential diagnosis, and evidence-based treatment selection.

FluencyArea 2 of 9

Fluency

Stuttering and cluttering across the lifespan.

The difference between developmental disfluency and persistent stuttering, risk factors for chronicity, the demands and capacities model, the Lidcombe Program for preschoolers, evidence-based approaches for school-age and adult stuttering, cluttering identification, and the role of avoidance and self-disclosure.

Fluency is a smaller area, but the questions tend to be conceptually tricky. Know your treatment frameworks cold, especially Lidcombe parameters and the difference between fluency shaping and stuttering modification.

Voice and ResonanceArea 3 of 9

Voice and Resonance

Voice disorders, resonance disorders, and laryngectomy rehabilitation.

Anatomy and physiology of voice production, common voice disorders (nodules, polyps, paralysis, presbylaryngis, MTD), instrumental assessment (videostroboscopy), perceptual rating scales (CAPE-V, GRBAS), resonance disorders (hypernasality, hyponasality, mixed), VPI causes and management, and laryngectomy rehab (electrolarynx, esophageal speech, tracheoesophageal puncture).

Voice questions often require integrating anatomy with assessment findings. Resonance and cleft palate questions tend to be application-level. Expect a clinical scenario, not a recall question.

Receptive and Expressive LanguageArea 4 of 9

Receptive and Expressive Language

Language disorders across the lifespan: DLD, aphasia, language-learning disabilities.

Typical language development milestones, Developmental Language Disorder (DLD), language-based learning disabilities, autism-related language profiles, aphasia types and their lesion sites (Broca's, Wernicke's, conduction, global, anomic, transcortical), assessment tools (CELF, PLS, BDAE, WAB), and evidence-based treatment approaches.

Language is one of the largest SLP knowledge areas. Aphasia questions are often clinically detailed, so know your fluent/nonfluent distinction and lesion correlates.

Social Communication / PragmaticsArea 5 of 9

Social Communication / Pragmatics

Pragmatic language disorders, autism, and social communication intervention.

Pragmatic milestones, social communication profiles in autism, social pragmatic communication disorder (SPCD), assessment of pragmatic skills, evidence-based interventions (PECS for some learners, video modeling, social stories, peer-mediated interventions), and the SLP role on multidisciplinary teams.

Pragmatics overlaps with autism, AAC, and language. Questions often blend two areas. Expect a child described with both pragmatic and language deficits, and you have to choose the priority intervention.

Cognitive CommunicationArea 6 of 9

Cognitive Communication

TBI, dementia, right-hemisphere damage, and executive function.

Cognitive-communication impairments after traumatic brain injury, dementia subtypes (Alzheimer's, vascular, frontotemporal, Lewy body, primary progressive aphasia), right-hemisphere damage profiles (anosognosia, neglect, prosody), Rancho Los Amigos levels, executive function assessment, and intervention approaches including spaced retrieval and external memory aids.

Cognitive communication is a major area for medical SLPs and a high-yield exam-prep topic. Dementia subtype differentiation is a frequent clinical reasoning stem.

Augmentative and Alternative Communication (AAC)Area 7 of 9

Augmentative and Alternative Communication (AAC)

Unaided and aided AAC, feature matching, and access methods.

AAC system types (unaided, aided, low-tech, high-tech), feature matching to user abilities, symbol systems (PCS, Bliss, line drawings), access methods (direct selection, scanning, eye gaze), partner-assisted scanning, vocabulary selection (core vs fringe), candidacy myths, and evidence-based AAC implementation including aided language stimulation.

AAC questions tend to be application-level. Expect clinical scenarios where you have to choose the right system or access method for a described user.

HearingArea 8 of 9

Hearing

Audiologic basics, hearing screening, aural rehabilitation, and the SLP scope.

Anatomy of the ear, conductive vs sensorineural vs mixed hearing loss, audiogram interpretation, hearing screening protocols, hearing aids and cochlear implants, aural rehab for adults and children, the SLP scope of practice in hearing (we screen, we rehab, audiologists diagnose), and the speech banana.

Hearing is smaller in volume but high leverage. Audiogram interpretation is the kind of skill that rewards concrete, repeated practice.

Feeding and Swallowing (Dysphagia)Area 9 of 9

Feeding and Swallowing (Dysphagia)

Dysphagia assessment and management across the lifespan.

Phases of swallowing, cranial nerves involved (V, VII, IX, X, XI, XII), bedside clinical swallow evaluation, instrumental assessment (MBSS/VFSS and FEES), penetration-aspiration scale, IDDSI levels, compensatory strategies vs rehabilitative exercises (Mendelsohn, Masako, Shaker, EMST), pediatric feeding disorders, and post-stroke/TBI dysphagia management.

Feeding and swallowing is a high-value review area. Cranial nerves, PAS scoring, and the difference between compensatory and rehabilitative strategies are useful concepts to practice.