What are indications for a referral regarding a communication impairment in a school-age child? (Select all that apply.)
a. Barely audible voice quality
b. Vocal pitch inappropriate for age
c. Intonation noted during speaking
d. Maintains a rhythm while speaking
e. Distortion of sounds after age 7 years
ANS: A, B, E
Barely audible voice quality, vocal pitch inappropriate for age, and distortion of sounds after age 7 years are indications for a referral regarding a communication impairment. Intonation noted while speaking and maintaining a rhythm while speaking are normal characteristics of speech.
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