JAAA CEU Program

Questions refer to Dwyer et al, “Contralateral Routing of Signal Yields Significant Speech in Noise Benefit for Unilateral Cochlear Implant Recipients,” 235–242.

Learner Outcomes:

Readers of this article should be able to:

• Summarize the impact of CROS on speech understating in cochlear implant listeners when speech originates from various azimuths.

• Identify how the magnitude of the head or face shadow might serve as a clinical tool in this population of patients.

CEU Questions:

1. After receiving a second implant, appreciable benefit is largely due to:

   • summation effects

   • overcoming the head shadow effect

   • binaural squelch (or binaural unmasking of speech)

2. In unilateral CI recipients, it is generally agreed upon that CROS overcomes the negative effects of the head shadow by:

   • increasing the effective SNR when the signal of interest originates from the side of the poorer hearing ear.

   • increasing the effective SNR when the signal of interest originates from the side of the better hearing ear.

   • increasing the effective SNR when the signal of interest originates from the front of the listener.

3. Which statement best reflects CROS outcomes in the current literature?

   • CROS is detrimental to speech understanding when noise is presented to the CI ear.

   • CROS improves speech recognition in quiet for unilateral listeners.

   • CROS benefit has been mixed.

4. In this study, speech recognition testing was completed:

   • immediately after CROS fitting.

   • after two weeks chronic use.

   • with AzBio sentence materials via monitored live-voice.

5. In this study, questionnaires of subjective benefit were administered:

   • immediately after CROS fitting

   • immediately before CROS evaluation, and after two weeks CROS use

   • with the Abbreviated Profile of Hearing Aid Benefit (APHAB)

6. The only listening condition that demonstrated statistically significant improvement with the addition of the CROS device was:

   • speech recognition in noise with the signal presented to the CI ear.

   • speech recognition in noise with the signal presented to the poorer ear.

   • speech recognition in noise with the signal presented to the front of the listener.

7. The difference in an individual’s ability to recognize speech when it is presented to the front of the listener vs. when it is presented to the CI side is called:

   • the head shadow effect

   • CROS benefit

   • the face shadow effect

8. The difference in an individual’s ability to recognize speech when it is presented to the listener’s CI side vs. when it is presented to the poorer hearing ear is called:

   • CROS benefit

   • the head shadow effect

   • the face shadow effect

9. Which of the following was not observed?

   • A significant correlation between the magnitude of the head shadow and CROS benefit for quiet speech (50 dBA) and speech in noise.

   • A significant correlation between the magnitude of the face shadow and CROS benefit for quiet speech (50 dBA) and speech in noise.

   • A significant correlation between the magnitude of the head shadow and CROS benefit for conversational level speech (65 dBA).

10. With the addition of the CROS device, participants reported significant improvement in which domain of the SSQ12 questionnaire?

    • speech hearing

    • spatial hearing

    • qualities of hearing