1. The fetus:
Begins to hear once the cochlea, auditory nerve and central nervous system connections have formed
Begins to hear during the third trimester
Hears low frequency sounds in utero such as the mother's hearbeat, breathing, voice and digestion
All of the above

2. During normal development of the ear:
The Organ of Corti develops before the spiral ganglion
The otic placode arises from the endoderm
Neuronal growth is guided in part by chemicals described as growth factors
The hair cells mature from base to apex

3.For children with severe to profound hearing loss, a cochlear implant:
Provides access to low frequency sound only
Consists of an electrode array placed into scala tympani of the cochlea
Delivers electrical pulses to hair cells
All of the above

4. At the initial stage of cochlear implant use:
auditory nerve responses are absent
EABR results indicate clear responses from the auditory brainstem pathways
Electrically evoked responses indicate an absence of cortical activation
a and c

5. After cochlear implantation, the auditory nerve and central auditory pathways gradually change, showing improvements in response to stimulation. Evidence for this maturation is based on the following:
ECAP latencies decrease and amplitudes increase
EABR latencies and interwave latencies decrease and amplitudes increase
Increased detectability of the EMLR with increased duration of implant use
All of the above

CEU questions and answers for article by John B. Christiansen and Irene Leigh entitled: Pediatric Cochlear Implants and Ethical Issues: Viewpoints to Consider. This was an invited article and is based on the book Cochlear Implants in Children: Ethics and Choices by Drs. Christiansen and Leigh published in 2002 by Gallaudet University Press. It was peer reviewed in November and December 2004 by Monica G. Pershey, Associate Editor of Hearsay and by Laura W. Kretschmer, Managing Editor of Hearsay. The article contains 4615 words excluding the references.

6. Which of the following groups of people were NOT represented in the interviews/surveys reported on by Christiansen & Leigh:
Parents of children who had received cochlear implants
Cochlear implant users including teenage recipients, former and current students at Gallaudet
Audiologists and physicians
Cochlear implant non-users including teenagers, former and current students at Gallaudet
Faculty and staff at Gallaudet, both deaf and hearing

7. Parents of children who were deaf reported which of the following experiences with regard to identification and management of their child's hearing loss?
Difficulty getting a definitive opinion about their child's hearing status
Both positive and negative experiences with professionals in the identification process
Conflicting views regarding the communication modality with their child both before and after implantation
Some reluctance by implant centers to forcefully recommend an implant
All of the above

8. Those professionals in favor of cochlear implants see the beneficent effects (in a bioethical sense) of cochlear implants to be:
Alleviation of a pathological condition that prevents the child from living a full life
Interference with a way of life in which the focus is not on the disability
Providing a device that will allow for an "open" future away from the constraints of the deaf community
Providing the deaf child with eventual freedom of choice about the society in which he/she wishes to live.
a, c and d

9. The deaf community members who were interviewed or surveyed about CIs mentioned all of the following concerns except:
Deaf children and adolescents are routinely asked about their wishes regarding implantation.
CIs do not meet the test of nonmaleficence (not causing harm) since deaf children without the implant can and do lead productive lives.
Deaf children without the implant are free of the struggles imposed by trying to be a part of hearing society.
The concern that not all implant teams include successful deaf adults, who are not CI users, as members.

10. Which of the following is NOT one of the conclusions that Christiansen and Leigh provide for this article:
Deaf persons can have a good quality of life with or without a CI.
CIs do not always separate a deaf child from the deaf community.
CIs almost always mean that the recipient will not choose to sign.
Early receipt of a CI will likely facilitate acquisition of spoken language if appropriate intervention is available.
Deaf persons can have satisfying lives using either signed or spoken communication.

CEU Questions and answers for Early Intervention for children with cochlear implants: a paradigm shift in expectations by Flexer, Robb, Wray and Sommers. Peer reviewed in December, 2004 and January, 2005 by Monica G. Pershey, Associate Editor and Laura W. Kretschmer, Managing Editor of Hearsay. There are 7079 words in this article excluding the appendices and references.

11. The positive neurological and communication outcomes with early intervention through auditory stimulation appear to be justified by all of the following EXCEPT:
Changes in evoked potential P1 reflecting changes in neuro-auditory maturation have been observed with early use of CIs.
Early CI use promotes intelligible speech in 90% of children implanted by 18 months of age.
Early hearing aid use in children with severe and profound hearing loss results in intelligible speech in 80% of children fit by 2 to 4 years of age.
Quality early intervention that includes appropriate CI mapping and adjustment and quality early intervention must be combined with implantation.

12. Which of the following factors is not considered critical by Flexer et al in the outcomes of successful early intervention, particular with CI technology?
The frequency of auditory development therapy
The nature and quality of technology and professional support
The role of IDEA part C in developing 0-3 services
Exclusive use of certified Auditory Verbal Therapists
The role of caregivers/family in the intervention process
The role of typically developing speech and language peers as models

13. The two cases studies provided about success of these young CI users suggest that which of the following principles is LEAST important:
Families' commitment to providing intervention to insure spoken language outcomes for their children
Having the state sponsored early intervention specialist coordinate services among professionals
Careful monitoring/troubleshooting of the CI
Frequent revisions/ discussion by all team members of each child's Individualized Intervention Plans
Classroom/preschool placement with typically developing children

14. In seeking a qualified EI specialist, parents should look for persons who have all of the following knowledge and abilities EXCEPT:
Persons with knowledge of the effects of hearing loss on language, speech, cognition and auditory brain development
Persons who are comfortable with troubleshooting CIs, hearing aids, FM systems and other technology that the child needs to utilize
Persons who are strongly committed to a particular intervention model
Persons who are willing to communicate with a variety of other professionals about the parents wishes for communication outcomes
Persons who encourage parents to be an integral part of the intervention program

15. The purposes of the Auditory Options Program (for children 0-3 years) developed in Ohio by the University of Akron and Kent State University are:
To replace the Ohio Department of Health Regional Infant Hearing Programs and Help Me Grow consultants
To provide free of change consultation and educational mentoring about auditory learning to various agencies and schools that request information
To develop qualified Auditory Verbal Therapists for the state of Ohio
To provide Parent Mentors to assist families around the state who are seeking information about auditory-oral alternatives for communication development in children with CIs and/or hearing aids.
a and c above
b and d above

CEU questions and answers for the research article entitled "Effect of Language Sample Size on MLUw" by Brorson and Dewey was peer reviewed by blind reviewers in October, November, 2004 and by Fofi Constantinidou, Research Forum editor for Hearsay in November, 2004. The final review and editing was by Laura W. Kretschmer, Managing Editor, Hearsay in January, 2005. The article is 5735 words in length, excluding references.

16. Historical review of the MLR (mean length of response) which became MLU (mean length of utterance) shows all but one of the following to be true about this language complexity measure:
Use of the MLR was first mentioned in 1937 by Mildred Templin.
Various researchers have recommended that 30-100 utterances should be collected to calculate MLR/MLU
Research on using various lengths of samples from 30-100 utterances have found conflicting results.
Language samples from which MLU is derived are one of the most common ways of describing grammatical complexity.

17. Research suggests that which of the following is not true about MLUm (morpheme) and MLUw (word)?
MLUm and MLUw computations have been shown to be strongly correlated in children between the ages of 24 and 48 months
MLUm/w increases with grammatical complexity until an MLU of approximately 4.5 is reached
MLUm/w calculation can provide important information about several aspects of language content, form and function.
MLU research has been conducted in a variety of languages including much research on American English
a and c above

18. The methods and analysis for this study of MLUw examined from a large number of language samples included all of the following EXCEPT:
Obtaining language samples from 402 children who were between the ages of 24 and 48 months
Selecting English language samples from the CHILDES data base developed by Jon Miller
Utilizing language samples from typically developing children that averaged 487 utterances per sample
Calculating and comparing MLUw from 7 different utterance sizes from the middle of each transcript for 4 age groups
There were non-significant effects for utterance sizes compared and for utterance sizes compared across age groups.

19. The results of this study of MLUw calculation should be taken to mean which of the following:
There were no significant differences between MLUw calculated from utterances subsets of 10, 25, 50, 100, 150, 200 or total sample size
The results were consistent for each of the four age groups between 24 and 48 months
The results were not consistent with other studies done on this question which suggested that as few as 10-20 utterances or as many as 50-100 could not be used to calculate MLUw/m
a and b above
a and c above

20. The authors offer several reasons for limiting generalizability of their research which included all of the following EXCEPT
Lack of representation from a number of different language sampling environments and geographic locations in the analyzed transcripts
Wide variations in ages of children from whom the samples were collected
The fact that most of the transcripts analyzed were obtained in the 1970's when topics and communication focus may have been quite different
Lack of information on racial and ethnic diversity of the whole sample and lack of a range of socio-economic status for children sampled
all of the above

CEU Questions for "Clinical Grand Rounds: Cochlear Implants: A closer look at a unique population" by Russell and Prasse. This article contains 3238 words excluding references. It was reviewed by Monica G. Pershey, Associate Editor and Laura W. Kretschmer, Managing Editor in January, 2005.

21. In general CI recipients have better outcomes, i.e., show enhanced listening and communication skills if they fall into which of the following categories:
Children with severe and profound hearing loss who are implanted by age 2
Children and adults who are prelingually deaf
Children and adults who are postlingually deaf
a & c above
a & b above

22. Teenagers who are deaf and receive CIs are a unique population because:
They are easily motivated to work on listening and speaking
They are difficult to motivate to work on listening and speaking
They are the best group at reporting on their auditory experiences which facilitates CI mapping.
None of the above

23. According to the studies referenced in this article, each the following seem to motivate adolescents toward therapy EXCEPT:
Need for after-school employment
Their peers
Discussion of personal experiences
Development of interpersonal relationships

24."Kathleen", the first teenager described, was successful before implantation because:
She was a successful communication due to her knowledge of language gained through early fitting with hearing aids and auditory/verbal instruction at home and at school
She had a transliterator with her in all her high-school classes
She was a successful communicator due to her knowledge of language gained through early fitting of hearing aids and the use of Cued Speech at home and at school.
All of the above

25. Ken, the second teenager described, had all of the following characteristics, EXCEPT:
Confidence in his ability to use the telephone
Problems with auditory memory
An implant recipient at an early age
A lack of interest in traditional speech and language therapy
a & c above

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