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Bimodal Fitting Revisited: Integrating Hearing Aid Optimization into Current Clinical Practice, in partnership with NAL

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1.  Which of the following factors has contributed to an increased number of unilateral CI recipients who use a HA in the opposite ear over the last decade?
  1. Technological advances in CI systems which have led to major improvements in the speech perception performance for CI users.
  2. The expansion of CI candidacy indications to include individuals with significantly more residual hearing than traditional candidates.
  3. Research has consistently shown that significant benefits can be obtained when people combine a hearing aid with a CI.
  4. All of the above.
2.  Which of the following is NOT an example of a potential bimodal benefit reported in the research literature for unilateral cochlear implant users who have residual hearing in the non-implanted ear?
  1. Improved speech perception in noise and reverberant conditions.
  2. Enhanced delivery of low-frequency cues via acoustic amplification.
  3. Facilitated lexical access through additional tone recognition, stress, and intonation pattern cues.
  4. A significant increase in listening effort in self-reported ratings of music enjoyment.
3.  Before commencing the NAL hearing aid fine-tuning procedure, which of the following criteria is NOT required?
  1. The client has a stable and comfortable cochlear implant MAP (listening program).
  2. The client has had at least one year of continuous cochlear implant use.
  3. Hearing thresholds in the non-implanted ear are stable.
  4. Client consistently worn HA in the non-implanted ear for at least 2- 4 weeks.
4.  The NAL bimodal fitting procedure does NOT involve which of the following steps?
  1. Evaluating binaural bimodal benefits using the Speech, Spatial and Qualities (SSQ12) questionnaire.
  2. Ensuring the cochlear implant program is comfortable and stable.
  3. Fitting the hearing aid using a validated hearing aid prescription and verifying the gain targets are met using real ear measures (REM).
  4. Adjusting the hearing aid gain to balance loudness between the two ears.
5.  Which of the following is NOT a suggested pre- or post-management step for patients with bimodal fittings?
  1. Continue to monitor hearing thresholds and hearing aid fitting in the non-implanted ear.
  2. Counsel on potential benefits of using amplification in the non-implanted ear pre and post implantation.
  3. Encourage the continued use of hearing aid in non-implanted ear only for those patients who express an interest in bilateral implantation.
  4. As a starting point, fit to a validated hearing aid prescription and verify gain targets are met using real ear measures (REM)

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