You suspect a patient shows catatonic speech disturbance. Before revealing the answer, decide how you would assess for this.

Listen carefully to the quality and delivery of spontaneous speech, separate from its content, noting any strange or stilted delivery that might make the patient sound unfamiliar with their own native language despite otherwise fluent vocabulary and grammar. Note any unusual intonation patterns, such as a falsetto tone, staccato rhythm, or nasal quality, and listen for a strangled vocal quality (Wurgstimme). Observe whether the patient whispers continuously, possibly suggesting they are responding to hallucinatory voices, or remains completely silent and expressionless despite appearing to attend to what is being said. Confirm that any oddity lies specifically in vocal quality and delivery, rather than in the accuracy or coherence of the content itself.