By Linda G. Gottermeier This article is a part of the September/October 2018, Volume 30, Number 5, Audiology Today issue. The case report described here draws attention to a powerful variable, namely offhanded provider remarks, which can negatively influence rehabilitation outcomes, specifically for prelingually deaf adults. This group is known to be highly variable in their audiologic/hearing characteristics (Neuman et al, 2017) such that blanket statements are not likely to apply to a given individual. Those in a position to counsel in rehabilitation fields have a special obligation to recognize the weight that their statements can carry in influencing decision-making by such clients (British Society of Audiology, 2012). When treatment options are presented with conflicting messages, a dilemma is created for the client, working against adoption of potentially valuable rehabilitation recommendations (Gagné, 2011; Laplante-Lévesque et al, 2012). In the case presented here, the issue was a bimodal fit for a young woman (we will call “CC”) with early-onset deafness and one cochlear implant (CI). Increasing numbers of individuals with prelingual, severe-profound hearing loss have been seeking greater access to sound in their late teens and adulthood (Sarant, 2012). For many in this group, one-sided CI use and listening training are usually the only recommendations, especially when previous listening experience or response to electric stimuli is inadequate or questionable (Boisvert et al, 2015). A hearing aid (HA) in the nonimplanted ear would be an alternative consideration to a second CI, but also has been rarely considered for this population, perhaps due to auditory deprivation of long duration, reports of unpleasant sensations during previous HA trials, and/or lack of objective test gains with a HA (Boisvert et al, 2015). Evidence now, however, supports use of a HA on the ear opposite the CI, known as a bimodal fit, as the standard of care for prelingually deaf adults with one CI (Berrettini et al, 2010; Gottermeier et al, 2016; Neuman et al, 2017). The protocol for a bimodal fit is key to its success. In the case described later, the individual had volunteered to participate in a three-week study of a bimodal fitting approach that employed frequent audiologist contact, repeated HA adjustments, and client journals as critical components, each found to be valuable in promoting favorable outcomes with bimodal hearing (adaptation, acceptance, and benefit) in this population (Berrettini et al, 2010; Gottermeier et al, 2016). Despite successes in producing remarkable changes with this protocol, the individual in this case study later abandoned her new HA because of beliefs planted earlier by a hearing health-care provider. This content is an exclusive benefit for American Academy of Audiology members. If you're a member, log in and you'll get immediate access. Member Login If you're not yet a member, you'll be interested to know that joining not only gives you access to top-notch resources like this one, but also invitations to member-only events, inclusion in the member directory, participation in professional forums, and access to patient resources, tools, and continuing education. Join today!