The candidate card
Setting
Private paediatric speech pathology clinic
Candidate
You are a speech pathologist. Last week you assessed Amira, aged 4, who was referred by her preschool teacher. She has a speech sound disorder, mainly replacing /k/ and /g/ with /t/ and /d/ (for example, 'tup' for 'cup'). You noted a mild tongue-tie, but her tongue movement for speech looked adequate. Her mother, Ms Abena Barbieri, has come back to discuss the results and start therapy, but she has asked for a letter supporting tongue-tie surgery instead.
Task (interlocutor: parent)
- Find out what Ms Barbieri has heard about tongue-tie and why she prefers surgery
- Explain in simple terms why the tongue-tie is unlikely to be causing Amira's speech errors (sounds made at the back of the tongue)
- Persuade her of the benefits of speech therapy (weekly sessions, short daily home practice)
- Respond to her concerns about time and commitment
- Agree a plan for therapy and next steps if she still wants a medical opinion about the tongue-tie
In the test you get 3 minutes to read the card and plan, then about 5 minutes to talk. This card is original, written for this site; the interlocutor's card is not shown.
How to approach this card
- Open with open questions about what Ms Barbieri has heard about tongue-tie and what she hopes surgery would change. Do not assume her reasons; find out first, because your explanation should answer her actual understanding.
- Acknowledge her request before disagreeing, then explain simply: Amira's errors are with sounds made at the back of the tongue, and her tongue movement for speech looked adequate. Use one example, like tup for cup.
- The usual trap is sounding dismissive of the tongue-tie or of her. Say you did see it and it is mild, and that you are not refusing her a medical opinion. Frame therapy as the proven next step, not an either-or.
- When she raises time and commitment, name it as a real concern and make the plan concrete: weekly sessions plus short daily practice that fits into routines. Ask what would make practice realistic in her week.
- If time is short, prioritise the explanation and a start date for therapy. Explain how she can seek a medical opinion about the tongue-tie, and that therapy need not wait for it. Close by checking her understanding.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- Tell me what you have heard about tongue-tie and what you hope surgery would help with.
- I can see why you want to explore this, and it is fine to get a medical opinion.
- Short daily practice is the part that tends to make the difference.
- What parts of your week would make a few minutes of practice hardest?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| speech sound disorder | Amira is mixing up some sounds, so some words come out different from how she means them. |
| ankyloglossia (tongue-tie) | The strip of tissue under the tongue is a bit short or tight. |
| velar sounds /k/ and /g/ | Sounds made at the back of the tongue, which Amira is replacing with sounds from the front. |
How this card is marked
Two assessors mark the recording on nine criteria: intelligibility, fluency, appropriateness of language and resources of grammar and expression (each 0–6), then relationship building, understanding and incorporating the patient's perspective, providing structure, information gathering and information giving (each 0–3). Grade B usually means 5 on each language criterion and 2 on each clinical one. See the AI Speaking practice guide for what each criterion looks for.
More Speech Pathology role-play cards
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All sets: nurses, doctors, other professions. Your profession's guide: OET Speech Pathology.
Questions about this role-play
How do I refuse the letter without sounding dismissive?
Separate the letter from her concern. Say you noted the tongue-tie, explain why it is unlikely to explain the back-of-tongue errors, and tell her she can see a medical practitioner for an opinion. Offer to start therapy now rather than wait.
How much detail on anatomy should I give?
Keep it to one idea: the sounds Amira gets wrong are made with the back of the tongue, and her tongue moved well enough for speech. One example like tup for cup is enough. Over-explaining can sound like you are arguing with her.
What if she says she has no time for daily practice?
Acknowledge it, then make practice small and fitted to routines she already has, and ask what is realistic. Explain that practice at home is what carries gains from sessions into everyday speech. Offer a review to adjust the plan if it is not working.
Sources
Last checked 22 Oct 2026. Rules and prices change: confirm on the official page before you book or apply.
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