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Speech Pathology

Read the following information.

Free OET Writing Sample Test with Answer Subtest Speech Pathology #10

Task: Adult Post-Stroke Dysphagia & Communication Impairment

Case Notes:

  • Patient: Mr. George Hamilton, 67 yrs

  • Referral Source: Neurology Ward

  • Reason for Admission: Left-sided ischemic stroke 10 days ago

  • Presenting Concerns:

    • Difficulty swallowing thin liquids ? frequent coughing and choking

    • Prolonged chewing with solids, occasional pocketing of food

    • Reduced vocal clarity post-meal, weak voice, difficulty being understood

    • Frustration and mild anxiety during mealtime

  • Medical History: Hypertension, hyperlipidemia

  • Medications: Aspirin 75 mg, Atorvastatin, Amlodipine

  • Examination: Left facial droop, reduced tongue strength, weak gag reflex, moderate dysarthria

  • Current Diet: Pureed solids and thickened liquids per nursing protocol

  • Referral Request: Comprehensive swallowing assessment, therapy plan for safe oral intake, voice and speech rehabilitation, caregiver education for feeding

To: Speech Pathology Team

Dear Speech Pathologist,

I am referring Mr. George Hamilton, a 67-year-old gentleman recovering from a left-sided ischemic stroke, for assessment and management of swallowing and communication difficulties.

Since his stroke ten days ago, Mr. Hamilton has experienced frequent coughing and choking with thin liquids, prolonged chewing of solids, and occasional food pocketing. He also exhibits reduced vocal clarity and a weak voice after meals, making it difficult for staff to understand his requests. These difficulties have caused frustration and anxiety during mealtimes.

Clinical examination revealed left facial weakness, reduced tongue strength, a diminished gag reflex, and moderate dysarthria. He is currently maintained on pureed solids and thickened fluids to minimize the risk of aspiration. His medical history includes hypertension and hyperlipidemia, managed with standard therapy, and he has no known prior swallowing issues.

We request a comprehensive swallowing and speech assessment, followed by individualized therapy to improve safe oral intake, voice strength, and intelligibility. Guidance for nursing staff and family on feeding strategies and communication support would be greatly appreciated. Early intervention is crucial for preventing complications, such as aspiration pneumonia, and for optimizing functional recovery and independence in communication.

Thank you for your expertise and support in managing Mr. Hamilton’s rehabilitation.

Yours faithfully,
Neurologist

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