Cochlear Implant Specialty Certification (CISC®) Examination Content

The two-hour, 100-question Cochlear Implant Specialty Certification (CISC®) examination is developed through a collaborative effort between the ABA and Human Resources Research Orginization (HumRRO). A group of audiology experts drawn from a wide variety of work environments and geographical areas write the examination questions. The examination consists of four-option, multiple-choice questions which are based on the following content outline.


  • Screen candidates for appropriate referral for implant evaluation
  • Describe the general cochlear implant process to the candidate
  • Take a pertinent case history
  • Review prior information from other professionals relevant to implant candidacy
  • Select the appropriate audiological tests to evaluate the candidate's hearing
  • Administer the appropriate audiological tests to evaluate the candidate's unaided hearing
  • Evaluate electroacoustic function of hearing aids
  • Administer the appropriate audiological tests to evaluate the candidate's aided hearing
  • Optimize hearing aid fitting if necessary
  • Interpret the results of the audiological tests
  • Refer for medical and other pertinent assessments
  • Integrate results from medical and other pertinent assessments
  • For the pediatric candidacy process integrate educational information (e.g. school input, speech language evaluations, educational performance, developmental progress)
  • Assess the availability of post-implant services
  • Recommend implantation based on pre-implant profile factors that contribute to candidacy selection
  • Determine the availability of support system (e.g. spouse, parents, employer, friends)


  • Provide accommodations to insure that the recipient/caregiver has access to all information during clinical interactions
  • Communicate the risks, benefits, limitations, costs, and precautions associated with cochlear implants
  • Establish open and trusting relationship with implant recipient/caregivers and other pertinent individuals who are necessary to support the rehabilitative process
  • Explain non-cochlear implant options and Deaf culture view to achieve language and educational goals
  • Communicate to recipient/caregiver issues regarding his or her candidacy, device selection, (including regulatory and investigational status) and the surgical component (within the audiologist's scope of practice) of the implant process
  • Communicate that general performance outcomes among implant recipients vary and are linked to a number of factors including pre-implant candidacy profile
  • Communicate the specific candidate's potential benefit from the device based on candidate's audiological and non-audiological pre-implant profile
  • Communicate to the candidate/caregiver issues regarding the ongoing care, management, and costs of the implant device, its accessories, and other assistive devices
  • Identify resources available to implant recipient/caregiver for information and support
  • Articulate the importance of a family's commitment to providing quality auditory input to the implant recipient
  • Determine if the candidate/caregiver understands the cochlear implant process
  • Determine if the candidate/caregiver has realistic expectations regarding outcomes
  • Educate candidates/recipients about improved outcomes due to technological advancements
  • Provide recipient with information on how and when to contact the manufacturer
  • Provide ongoing counseling as needed


  • Collaborate with surgeon to select appropriate implant system based on anatomic/etiologic factors
  • Counsel user/family regarding postoperative medical considerations within audiology scope of practice
  • Refer to surgeon when identified problem is outside audiology scope of practice
  • Recommend ear selection for implantation based on audiological findings


  • Determine parameters of software for the appropriate device
  • Set up the necessary external programming and recipient equipment
  • Instruct recipient in task(s) accommodating his/her communication needs
  • Integrate results of impedance telemetry with programming systems
  • Apply principles of individual programming systems relative to coding strategy
  • Measure psychophysics
  • Assess appropriateness of the program to insure comfort
  • Adjust parameters based on recipient's/caregiver's perception to improve sound quality and performance
  • Confirm that electrodes deliver auditory percepts
  • Assess performance formally or informally
  • Determine schedule of use of programs in the processor
  • Specify follow-up schedule for reprogramming
  • Select the most appropriate strategy and parameters based on recipient characteristics (common cavity, otosclerosis, partial insertion, prior auditory experience)
  • Recognize the need for input from other professionals (i.e. issues outside of audiology scope of practice)
  • Program implant system using electrically evoked compound action potential
  • Adjust settings based on electrode compliance


  • Identify to the recipient/caregiver the primary elements of cochlear implant operation
  • Demonstrate to the recipient/caregiver how volume and sensitivity affect perceived loudness
  • Counsel recipient/caregiver regarding microphone placement
  • Determine appropriate type of processor based on recipient's age and other factors
  • Educate recipient/caregiver regarding importance of magnet strength
  • Integrate assistive listening devices/accessories (includes additional microphones, telephones, and other audio signals) with speech processor
  • Educate recipient/caregiver on use and maintenance of the device and all accessories
  • Review precautions and warnings with recipient/caregiver


  • Systematically assess function of individual external components
  • Develop action plan if external device malfunctions
  • Systematically assess function of internal components
  • Develop action plan if internal component malfunctions
  • Teach recipient/caregiver/professional how to troubleshoot interfacing the device with other inputs (e.g. FM systems, external microphone)
  • Determine the factors beyond equipment malfunction which can cause degraded signal transmission
  • Adjust settings based on electrode impedance


  • Elicit feedback regarding auditory behavior from implant recipient, family, and primary rehabilitation personnel
  • Apply knowledge of implant recipient's speech perception and speech production as a function of mode of communication to rehabilitation recommendations
  • Apply knowledge of stages of auditory skill development to assist implant recipients/caregivers, teachers , or therapists in the development of age and skill-appropriate listening activities
  • Guide recipients/caregivers to experienced professionals in the recipient's community who are available to provide appropriate education/rehabilitation services
  • Identify resources available to other professionals working with implant recipients for the purpose of assessment, rehabilitation, and continuing education


  • Administer qualitative scale of performance and satisfaction with cochlear implant use
  • Assess thresholds of sound detection using implant in a calibrated test environment
  • Assess speech perception skills using developmentally appropriate tests
  • Apply results of speech perception error analysis to revise processor programming if appropriate
  • Assess cochlear implant user's ability to operate and maintain the processor and accessories
  • Assess the benefit of contralateral hearing devices
  • Assess the benefit of assistive listening devices
  • Assess cochlear implant user's ability to adjust the processor for varying listening conditions
  • Assess cochlear implant user's ability to use compensatory strategies to communicate in group and noisy situations
  • Integrate feedback from the educators/rehabilitation specialists to assess rate of progress
  • Recommend modifications in therapy or listening environments based on measured progress

Sample Examination Questions

Following are sample questions in the same style and similar content as will be on the examination. Use the sample questions to verify your understanding of the topics in the examination. Answers are provided below.

  1. An electrode array is typically inserted into the cochlea through the
    1. oval window
    2. round window
    3. cochleostomy
    4. internal auditory canal
  2. A processor is programmed so that progressively higher stimulation levels reside in multiple programs after the patient's activation appointment. The most likely reason for this set-up is to allow the patient to
    1. increase stimulation levels while they grow accustomed to the sounds.
    2. change the loudness of the processor depending on the loudness of the environment.
    3. have a backup of the previously used program on their processor in case of memory corruption.
    4. predict stimulation levels of the next programming appointment.
  3. The child's parents have decided to enroll him in their neighborhood elementary school. Which of the following is likely to be the LEAST effective accommodation for his classroom environment?
    1. small class size
    2. real-time captioning
    3. FM assistive device
    4. visual alerting system

Sample Questions – Answer Key

Please use this answer key to evaluate your responses.

  1. C
  2. A
  3. B