Argenyi v. Creighton University

Filing 286

PRETRIAL ORDER - estimated length of trial is 4 days; Jury Trial set for 8/20/2013 at 09:00 AM in Courtroom 2, Roman L. Hruska Federal Courthouse, 111 South 18th Plaza, Omaha, NE before Chief Judge Laurie Smith Camp.Ordered by Magistrate Judge F.A. Gossett. (GJG)

Fl LED

US DISTRICT COURT
DISTRICT OF NEBRASKA

IN THE UNITED STATES DISTRICT COUR r
FOR THE DISTRICT OF NEBRASKA

JUL 2 5 2013
OFRCE OF THE CLERK

MICHAEL S. ARGENYI,
Plaintiff( s),
vs.
CREIGHTON UNIVERSITY,
Defendant( s).

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Case No. 8:09cv341

ORDER ON
FINAL PRETRIAL
CONFERENCE

A final pretrial conference was held on the 22nd day of July, 2013.
Appearing for the parties as counsel were Mary Vargas and Dianne DeLair for
Plaintiff and Scott Parrish Moore and Allison D. Balus for Defendant.
(A)

Exhibits. See attached Exhibit List.

(B) Uncontroverted Facts. The parties have agreed that the following
may be accepted as established facts for purposes of this case only:
1.
Defendant is a "place of public accommodation" for purposes of the
Title III of the Americans with Disabilities Act, 42 U.S.C. ("ADA").
2.

Defendant is a recipient of Federal Financial Assistance for purposes
of Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794
("Section 504").

3.

Plaintiff has a "disability" as defined by the ADA and Section 504.

4.

Plaintiff was admitted to Creighton University School of Medicine
and has successfully completed his M 1 and M2 years using auxiliary
aids and services he provided himself.

5.

Plaintiff requested and was granted a leave of absence after he
completed his M2 year pending the outcome of this case.

6.

Argenyi paid approximately $51,002.50 for auxiliary aids at
Creighton University during his first year of medical school.

7.

Argenyi paid approximately $59,719.12 for auxiliary aids at
Creighton University during his second year of medical sch<;>ol.

(C) Controverted and Unresolved Issues. The issues remaining to be
determined and unresolved matters for the court's attention are:
Joint Statement of Controverted Issues:
1.

Whether any of parties' pending Motions in Limine should be granted;

2.

Whether Plaintiffs pending Motion for Partial Summary Judgment
should be granted or denied;

3.

If liability is found against Defendant, whether Defendant acted with
"deliberate indifference" in refusing to provide auxiliary aids and
services to ensure effective communication.

4.

If Defendant is found liable, what damages, if any, should be awarded
to Argenyi.

5.

If liability is found against Defendant under Title III of the ADA and
Section 504, what injunctive relief, if any, should be awarded (to be
determined by the Court).

Plaintiff's Statement of Controverted Issues:
1. Whether Defendant violated Title III of the ADA and/or Section 504:

a.

Whether Defendant provided the auxiliary aids and services
necessary for effective communication;

b.

Whether Defendant is entitled to assert and has proved that the
provision of the needed auxiliary aids and services amounted to
2

an undue burden when taking into account the overall financial
resources of the Defendant.
Defendant's Statement of Controverted Issues:

1. Whether Defendant violated Title III of the ADA or Section 504:
a.

Whether Defendant failed to provide Plaintiff a necessary
reasonable modification and/or auxiliary aid or service;

b.

Whether the modifications and/or auxiliary aids and services
requested by Plaintiff that Defendant did not provide were
actually necessary to afford Plaintiff access to a medical
education;

c.

Whether making the modifications requested by Plaintiff and/or
providing the auxiliary aids and services requested by Plaintiff
would fundamentally alter the nature of the medical education
offered by Defendant or would result in an undue burden upon
Defendant.

2. The parties disagree as to the appropriate legal standard for deliberate
indifference.

(D) Witnesses. All witnesses, including rebuttal witnesses, expected to be
called to testify by plaintiff, except those who may be called for impeachment
purposes as defined in NECivR 16.2(c) only, are: See Attached Witness List.

All witnesses expected to be called to testify by defendant, except those who
may be called for impeachment purposes as defined in NECivR 16.2(c) only, are:
See Attached Witness List.
It is understood that, except upon a showing of good cause, no witness

whose name and address does not appear herein shall be permitted to testify over
objection for any purpose except impeachment. A witness whose only testimony is
intended to establish foundation for an exhibit for which foundation has not been
waived shall not be permitted to testify for any other purpose, over objection,
3

unless such witness has been disclosed pursuant to Federal Rule of Civil Procedure
26(a)(3). A witness appearing on any party's witness list may be called by any
other party.
(E) Expert Witnesses' Qualifications. Experts to be called by plaintiff
and their qualifications are set forth in the attached materials.
Plaintiff requests that the Court allow the submission of supplemental expert
qualification materials no later than five (5) days before trial.
Defendant objects to any supplemental expert qualification materials as the
deadline for supplementing expert materials has long past, discovery has closed,
and such a late disclosure would be extremely prejudicial to Defendant.
(F) Voir Dire. Counsel have reviewed Federal Rule of Civil Procedure
47(a) and NECivR 47.2(a) and suggest the following with regard to the conduct of
juror examination:

The parties request that the Court allow the submission of voir dire questions
no later than five (5) days prior to the first day of trial (i.e. August 16, 2013)
and that the Court conduct a preliminary examination of prospective jurors,
with counsel for both parties asking follow-up questions.
(G) Number of Jurors. Counsel have reviewed Federal Rule of Civil
Procedure 48 and NECivR 48.1. Plaintiff suggests that this matter be tried by a
jury composed of 6 members. Defendant suggests that this matter be tried to a jury
composed of 12 members.
(H) Verdict. The Plaintiff will stipulate to a less-than-unanimous verdict.
The Defendant will not stipulate to a less-than-unanimous verdict.

4

Briefs, Instructions, and Proposed Findings.
Counsel have
reviewed NECivR 39.2(a), 51.1(a), and 52.1, and suggest the following schedule
for filing trial briefs, proposed jury instructions, and proposed findings of fact, as
applicable:
(I)

Unless otherwise ordered, trial briefs, proposed findings of fact, and
proposed jury instructions shall be filed five (5) working days before the
first day of trial (i.e. August 13, 2013). Objections to proposed jury
instructions shall be filed two (2) working days before the first day of trial
(i.e. August 16, 2013).

Length of Trial. Plaintiffs Counsel estimates the length of trial will
consume not less than 3 day(s), not more than seven (7) day(s), and probably about
4 day(s).
(J)

Defendant's Counsel estimates the length of trial will consume not less than
3 day(s), not more than four (4) day(s), and probably about 4 day(s).

(K)

Trial Date. Trial is set for August 20, 2013 in Omaha, Nebraska.

(L) Demonstratives. Any demonstrative is to be disclosed to the opposing
party by 9:00a.m. on the business day before it is intended to be used.

(M) Witnesses. The parties agree to identify witnesses to be called to testify by
9:00a.m. on the business day before they will testify. Witnesses may be removed
from but not added to the list by 5:00 p.m. the business day before the witnesses
will testify.

5

MICHAEL S. ARGENYI, Plaintiff
By:

s/ Mary C. Vargas
MARY C. VARGAS (MD# 14135)
MICHAEL S. STEIN
Stein & Vargas, LLP
5100 Buckeystown Pike, Suite 250
Frederick, MD 21704
[phone]
Mary. [e-mail]
Is/Dianne D. DeLair, #21867
Disability Rights Nebraska
Federal Trust Building
134 S. 13th Street, Suite 600
Lincoln, NE 68508
Phone: [phone]
Fax: [phone]
Email: [e-mail]

Attorneys for Plaintiff

CREIGHTON UNIVERSITY, Defendant,
By: s/Scott P. Moore
Scott Parrish Moore (NE # 20752)
Allison D. Balus (NE # 23270)
of BAIRD HOLM LLP
1500 Woodmen Tower
Omaha, NE 68102-2068
Phone: [phone]
Fax: [phone]
[e-mail]

Attorneys for Defendant

6

F.A. Gossett, III
United States Magistrate Judge
DOCS/1197272.4

7

IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF NEBRASKA

MICHAEL S. ARGENYI,
Plaintiff( s),
vs.
CREIGHTON UNIVERSITY,
Defendant( s).

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Case No. 8:09cv341

PARTIES' JOINT
TRIAL EXHIBIT LIST

*

Objections
Materiality - M Hearsay - H
Relevancy- R Foundation- F
Au thenf ICHY- A Other- 0
.t

Trial Dates:

EXHIBIT
NO.
DESCRIPTION
1

2

3

4

5

Letter from Michael Argenyi to
Michael Kavan March 23,2009, and
attached Request for Accommodation
and attached audiograms dated March
4,2009
Email chain Michael Argenyi and
Michael Kavan
April1, 7, 8, 2009
Email Michael Argenyi to Michael
Kavan
April24, 2009
Letter from Michael Kavan to
Michael Argenyi
May 18,2009
Letter from Michael Argenyi to

AS
NEEDED

OFF
X

p

D

X

p

D

X

OBJ

DATE
RCVD

NOT
RCVD

EXHIBIT
NO.
DESCRIPTION

6

7

8

9

10

11

12

13

14

Michael Kavan
M<!Y_ 26, 2009
Letter from Michael Kavan to
Michael Argenyi
June 23, 2009
Email Michael Argenyi to Michael
Kavan
July 15, 2009
Class Schedule M1
August 2009
Email Michael Argenyi to Michael
Kavan
September 1, 2009
Email from Michael Argenyi to
Michael Kavan September 15, 2009,
and attachment Letter from Esther
Argenyi to Michael Kavan
Email Michael Argenyi to Michael
Kavan
September 21, 2009
Email Michael Argenyi to Michael
Kavan
September 24, 2009
Letter from Richard Okamoto to Amy
Bones
October 30, 2009
Email Chain Jodi Lange and Rebecca
Cory
October 30, 2009

15

Email Chain Jodi Lange and Dimitri
Azadi
October 30, 2009

16

Letter from Dr. Backous and Stacey
Watson to Michael Kavan
April 10,2009

AS
NEEDED

p

OFF

OBJ

D

X

X
X

X

M,
H,
R,F,
A,O

X

X

X

X

M,
H,
R,F,
A,O

X

M,
H,
R,F,
A,O
X

DATE
RCVD

NOT
RCVD

EXHIBIT
NO.
DESCRIPTION
17

18

19

20
21

Letter from Dr. Backous and Stacey
Watson to Michael Kavan
May 27,2009
Letter from Dr. Backous and Stacey
Watson to Michael Kavan
September 10, 2009
Letter from Dr. Backous and Stacey
Watson to Michael Kavan
September 28, 2009
Letter from Dr. Britt Thedinger
May 6, 2010
Audiogram, Ear Specialists of Omaha
May 6, 2010 and Hearing in Noise
Test Results pages 18, 52, 57
May6, 2010

AS
NEEDED

OFF

OBJ

X

X

X

X
M,
R,
H,
F,O

22

Email Chain Michael Argenyi and
Thomas Hansen
September 21, 2010

M,
H,
R,F,
A,O

23

Email from Michael Argenyi to
Thomas Hansen
October 8, 2010

M,
H,
R, F,
A,O

24

Email from Michael Argenyi to
Thomas Hansen
October 20, 201 0

M,
H,
R, F,
A,O

25

Email from Michael Argenyi to
Thomas Hansen
December 6, 2010

M,
H,
R, F,
A,O

26

Email from Michael Argenyi to
Thomas Hansen
April 7, 2011

M,
H,
R, F,
A,O

27

Calendars Maintained by Floyd
Knoop

M,
H,

DATE
RCVD

NOT
RCVD

EXHIBIT
NO.
DESCRIPTION

AS
NEEDED

OFF

OBJ

October 2009 - May 2010

R,F,
A,O

28

Resume of Margaret Heaney

M,
H,
R,O

29

M,
H,
R,
A,
F, 0

30

Expert Report of Margaret Heaney
and attachments including Addendum
email, Fee Schedule, CART
Reporting, CART in the Classroom,
General Guidelines for CART,
Lecture #66 with handwritten
notations, The Neuropsychology of
Court Reporting
Federal Funds Accepted by Creighton

31

Creighton University's Endowment

M,
H,
R, F,
A,O

32

Answers and Objections to Plaintiffs
First Request for Production of
Documents
Pages 1, 6, and 9

M,
H,
R, F,
0

33

Letter from Esther Argenyi to Dr.
Zetterman with attachment Letter
from Esther Argenyi to Michael
Kavan
September 7, 2009
Email Michael Kavan to Michael
Argenyi
September 15, 2009
Email Floyd Knoop to Philip Brauer,
et al.
September 28, 2009
Charts of Auxiliary Aids Provided by

34

35

36

M,
H,
R, F,
A,O

X

p

M,
H,
R,F,
A,O
D

X

X

M,

DATE
RCVD

NOT
RCVD

EXHIBIT
NO.
DESCRIPTION

AS
NEEDED

38

Audiogram
March 4, 2009
Confidentiality Agreement signed by
Ronda Rankin
January 13, 2011

OBJ
H,
R,F,
A,O

Michael Argenyi for M1

37

OFF

X

M,
H,
R,F,
A,O
M,
H,
R,F,
A,O

39

Confidentiality Agreement signed by
Bethany Koubsky
January 13, 2011

X

40

Email from Alice Smith to Michael
Kavan
May6, 2009
Costs Michael Argenyi Paid for
Auxiliary Aids and Services at
Creighton University

X

X

M,
H,
R, F,
A,O

42

Costs Michael Argenyi Paid for
Auxiliary Aids and Services By
Semester and Year

X

M,
H,
R,F,
A,O

43

Vita of Peter Seiler

X

M,
H,
R,O

44

Expert Report of Peter Seiler

X

M,
H,
R,O

45

Audiogram of Michael Argenyi with
facsimile cover sheet to Richard
Okamoto
Cover Sheet dated July 23, 2004 and
Audiogram dated May 18, 2004
Learning Center Notes and Notes of

X

M,
H,
R,F,
A,O

X

M,

41

46

DATE
RCVD

NOT
RCVD

EXHIBIT
NO.
DESCRIPTION

AS
NEEDED

OFF

OBJ
H,
R,F,
A,O

Richard Okamoto
May 7, 2004
Invoices and Receipts for Ml
Auxiliary Aids
Invoices and Receipts for M2
Auxiliary Aids
Creighton University Organizational
Chart

X

X

M,
R,O

50

Creighton University Strategic Plan
Overview (Cover and Pages 14-15)

X

M,
R,O

51

USASpending.gov Summary Results
for Creighton University

X

M,
H,
R,F,
A,O

52

USASpending.gov Prime Award
Spending Data Creighton University
2009 Pages 1-16, 1-14, 1-14 (44
pages including 300 Transactions)

X

M,
H,
R, F,
A,O

53

USASpending.gov Prime Award
Spending Data Creighton University
2010 Pages 1-16, 1-14, 1-15, 1-15 60
Pages Including 400 Transactions)

X

M,
H,
R, F,
A,O

54

USASpending.gov Prime Award
Spending Data Creighton University
2011 Pages 1-15 (100 Transactions)

X

M,
H,
R,F,
A,O

55

Creighton University Financial
Report 2009

X

M,
R,O

56

Creighton University Financial
Report 2010

X

M,
R,O

57

Creighton University Financial
Report 2011

X

M,
R,O

58

Complaint Filed with Office for Civil
Rights by Christopher Moreland

X

M,
H,
R,F,

47
48
49

X

DATE
RCVD

NOT
RCVD

EXHIBIT
NO.
DESCRIPTION

AS
NEEDED

OFF

OBJ
A,O

59

Letter of Finding, U.S. Department of
Education
July 13, 2007

X

M,
H,
R, F,
A,O

60

Deafness Among Physicians and
Trainees: A National Survey,
Academic Medicine, Christopher
Moreland, et al., Volume 88, No.2
February 2013
Video "Technology Assures Deaf
Students Learn Surgery"
http://www .youtube.com/watch?v=A
wDvgFrbY5w
Video Exhibit
November 30, 2011
Spreadsheets of Auxiliary Aid Costs
Paid by Argenyi for M1

X

M,
H,
R,F,
A,O

X

M,
H,
R,F,
A,O

X

M,
H,
R,F,
A,O

61

62

63

Spreadsheets of Auxiliary Aid Costs
Paid by Argenyi for M2

X

M,
H,
R,F,
A,O

64

Spreadsheets of Loans for Auxiliary
Aids

X

M,
H,
R,F,
A,O

65

Letter from Scott Moore to Dianne
DeLair
February 23, 2010

X

M,
H,
R,F,
0

200

Plaintiffs Application Creighton
Medical School

*FA
RM

DATE
RCVD

NOT
RCVD

EXHIBIT
NO.
DESCRIPTION

AS
NEEDED

OFF

OBJ
HO

201

Technical Standards for Creighton
Medical School

*FA
RM
HO

202

Letter dated June 2, 2009, from
Amanda Mogg to Kavan

*FA
RM
HO

203

Email dated August 18, 2009, from
Kavan to Plaintiff
Letter dated August 27, 2009, from
Amy Bones to Dianne DeLair

204

*F
AR
M
HO

205

Plaintiffs examination results/Grade
Reports

*FA
RM
HO

206

Letter dated September 21, 2009,
from A. Bones to D. DeLair

*FA
RM
HO

207

Emails regarding offer to provide
interpreter for Plaintiff to participate
in memorial service

FAR
MH
0

208

Applied Clinical Skills IDC 290

209

DVDs ofPlaintiffs participation
OSCEs

*FA
RM
HO

210

Emails exchanged among Plaintiff,
Kavan, and Creighton staff regarding
selecting FM Assistive Listening
Device
Creighton University School of
Medicine Handbook

*FA
RM
HO

211

212

Emails dated July 13,2010, from
Scott P. Moore to Mary Vargas with
attached M2 Syllabi

*FA
RM
HO
*FA
RM
HO

DATE
RCVD

NOT
RCVD

EXHIBIT
NO.
DESCRIPTION
213
214

AS
NEEDED

Letter dated July 28, 2010, from
Dianne DeLair to Scott P. Moore
Letter dated August 13, 2010, from
Scott P. Moore to Dianne DeLair

OFF

OBJ

DATE
RCVD

*FA
RM
HO

215

Emails exchanged between Creighton
staff regarding providing closed
caption videos

FAR
MH
0

216

Services for Students with
Disabilities

FAR
MH
0

217

Invoices relating to purchases of FM
System and auxiliary aids for Plaintiff

FAR
MH
0

218

Medical records from the Listen for
Life Center

X

FAR
MH
0

219

Pre-Cochlear Implant Documentation

X

FAR
MH
0

DATED this the 19th day of July, 2013.

MICHAEL S. ARGENYI, Plaintiff,
By:

s/Mary C. Vargas
MARY C. VARGAS (MD# 14135)
MICHAEL S. STEIN
Stein & Vargas, LLP
5100 Buckeystown Pike, Suite 250
Frederick, MD 21704
[phone]
Marv.V [e-mail]
Attorneys for Plaintiff

NOT
RCVD

CREIGHTON UNIVERSITY, Defendant,
By: s/Scott P. Moore
Scott Parrish Moore (#20752)
Allison D. Balus (#23270)
BAIRD HOLM LLP
1500 Woodmen Tower
Omaha, NE 681 02
Phone: [phone]
Fax:
[phone]
[e-mail]
[e-mail]
Attorneys for Defendant

DOCS/1197282.1

8:09-cv-00341-LSC-FG3 Doc# 263 Filed: 07/02/13 Page 1 of 3- Page ID # 3704

IN THE UNITED STATES DISTRICT COURT FOR THE
DISTRICT OF NEBRASKA

MICHAEL S. ARGENYI,
Plaintiff,

v.
CREIGHTON UNIVERSITY,
Defendant.

Case No. 8:09-CV-341

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PLAINTIFF'S NON-EXPERT
WITNESS LIST

COMES NOW Plaintiff, MichaelS. Argenyi, and makes the following pre-trial
disclosures pursuant to the Court's Amended Order Setting Final Schedule for
Progression of Case (Doc #243): Witness List.

PLAINTIFF EXPECTS TO PRESENT:
MichaelS. Argenyi
c/o Plaintiff's counsel
Dr. Britt A.Thedinger
Omaha, NE 68114
Richard Okamoto
Seattle, WA 98122-1090

Margaret Heaney
Omaha, NE 68131

Christopher S. Moreland, M.D.
New Braunfels, TX 78130

Michael G. Kavan, Ph.D.
Omaha, NE 68178

1

8:09-cv-00341-LSC-FG3 Doc# 263 Filed: 07/02/13 Page 2 of 3- Page ID # 3705

Thomas Hansen
Omaha, NE 68178

Floyd Knoop, M.D.
Omaha, NE 68178
Ronda Rankin, AAS, NIC, QAST IV
Omaha, NE

PLAINTIFF MAY CALL IF THE NEED ARISES:
Douglas D. Backous, M.D.
Seattle, WA 98111
Stacey D. Watson
Seattle, WA 98111
Brenna Carroll
Seattle, WA 98111

Pam Madsen
Omaha, NE 68178
Esther E. Argenyi, M.D.
Woodinville, WA 98072
Robert Pollard
Rochester, NY 14642
Alice Smith (to establish foundation)
c/o defense counsel
Jodi Lange (to establish foundation)
Omaha, NE 68178
Plaintiff, Michael S. Argenyi,
BY:

/s/ Dianne Delair
Disability Rights Nebraska
Federal Trust Building
2

8:09-cv-00341-LSC-FG3 Doc# 263 Filed: 07/02/13 Page 3 of 3- Page ID # 3706

134 S. 13th Street, Suite 600
Lincoln, NE 68508
Tel: [phone]
Fax: [phone]
[e-mail]
Mary C. Vargas, #14135 (District Court)
Michael S. Stein, Esq.
Stein & Vargas, LLP
5100 Buckeystown Pike, Suite 250
Frederick, MD 21704
Tel: [phone]
Fax: [phone]
mary. [e-mail]
Marc Charmatz, #09358 (District Court of MD)
National Association for the Deaf
Law and Advocacy Center
Legal Department
8630 Fenton Street, Suite 820
Silver Spring, MD 20910
Tel: [phone]
Fax: [phone]
[e-mail]

CERTIFICATE OF SERVICE

I hereby certify that on July 2, 2013, I electronically filed the foregoing with the
Clerk of the Court using the CM/ECF system which sent notification of such filing to the
following:
Scott P. Moore
Chris Hedican
Allison Salus
/s/ Dianne D. Delair

3

IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF NEBRASKA

MICHAEL S. ARGENYI,
Plaintiff(s),
vs.
CREIGHTON UNIVERSITY,
Defendant( s).

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Case No. 8:09cv341

DEFENDANT'S TRIAL WITNESS
LIST

Defendant, Creighton University, makes the following disclosures of its witnesses for
trial:
1.

The name and the address of each individual Defendant expects to present at trial to

testify:
Michael G. Kavan, Ph.D.
Creighton University School of Medicine
2500 California Plaza
Omaha, NE 68178
[phone]
Wade Pearson
Creighton University
2500 California Plaza
Omaha, NE 68178
[phone]
Floyd C. Knoop, PhD
Creighton University School of Medicine
2500 California Plaza
Omaha, NE 68178
[phone]
Chuck Lenosky
Creighton University School of Medicine
2500 California Plaza
Omaha, NE 68178
[phone]

Stacey D. Watson, MS, CAA 1
The Listen for Life Center at Virginia Mason
1100 Ninth Avenue
Seattle, WA 98111
[phone]
Tom Pisarri
Creighton University School of Medicine
2500 California Plaza
Omaha, NE 68178
[phone]
Eugene Barone
Creighton University School of Medicine
2500 California Plaza
Omaha, NE 68178
[phone]
Thomas Hansen
Creighton University School of Medicine
2500 California Plaza
Omaha, NE 68178
[phone]
Dianne DeLair (solely for foundation)
Disability Rights Nebraska
Federal Trust Building
134 S. 13th Street, Suite 600
Lincoln, NE 68508
[phone]
Mary Vargas (solely for foundation)
Stein & Vargas, LLP
51 00 Buckeystown Pike, Suite 250
Frederick, MD 21704
[phone]
Plaintiff
1 Defendant sought to withdraw this witness, but Magistrate Judge Gossett ruled that she must be kept on
the list. Defendant objects to listing this witness unless the Court allows it to depose her before trial.

2.

The name and the address of each additional individual likely to testify for

Defendant if the need arises:
Kathryn Huggett
Creighton University School of Medicine
2500 California Plaza
Omaha, NE 68178
[phone]
Brianna Scott
Creighton University School ofMedicine
2500 California Plaza
Omaha, NE 68178
[phone]
Terry Zach
Creighton University School of Medicine
2500 California Plaza
Omaha, NE 68178
[phone]
Christy A. Rentmeester
Creighton University School of Medicine
2500 California Plaza
Omaha, NE 681 78
[phone]
Jan Madsen
Wade Pearson
Creighton University
2500 California Plaza
Omaha, NE 68178
[phone]
Theresa Townley
Creighton University School of Medicine
2500 California Plaza
Omaha, NE 681 78
[phone]
Margaret Tyska Heaney, RPR

406 South 48th A venue
Omaha, Nebraska 68132
[phone]
Richard Okamoto (To be called by deposition)
2114 S. State Street
Seattle, W A 98114
[phone]

DATED this the 25th day of July, 2013.
CREIGHTON UNIVERSITY Defendant,
By: s/Scott P. Moore
Scott Parrish Moore (#20752)
Allison D. Balus (#23270)
BAIRD HOLM LLP
1500 Woodmen Tower
Omaha, NE 681 02
Phone: [phone]
Fax:
[phone]
[e-mail]
[e-mail]
Attorneys for Defendant

DOCS/1193825. 7

,..

08/03/2010 12:38

froa:

MARGARET lYSKA HEANEY, RPR, CSR
406 South 48111 Avenue
Omaha, Nebraska 68132
[phone]

PERSONAL:

1748 P. 012/014

...

Blrthdate- Febrwry 7, 1963
Married - Christopher J. Heaney, &/VJ/86
Chlldnan - Stanislaus Joseph, a1a19
Mqrlan Janae, ap 14
Robert Gaovannl, ap 7

EDUCATION:

Metropolitan Community Collese, Omaha, ·Nebraska
Deaf CUlture
American Sian Lanpqe I -IV
Dean's Ust
Auplst 2007- December 2009.
Loyola University, New Orleans, LA
Bachelor's Dearee of MusJc Business
Aupst 1981- May 1985.
Institute for Lepl Studies, Metairie, LA
Associate's Dqrse of Court Reportlns
Mav 1988- May 1990.

PROFESSIONAL
EXPERIENCE:

2010- CART Provider CEASD (Conference of Educational Administrators of
Schools for the Deaf) Annual Conference, Council Bluffs, Iowa

September 2009- May 2010- CreiJbton University School of Medicine,

Omaha, Nebraska. CART Provider for fltst-vear medical student, lncludfns
lectures. computer lab, anatomy lab, Grand Rounds.
2007-2008 Thomas & Thomas Court Raporten, Unc:oln, Nebraska. Realtime
reporter for patent lftflatlon- BASF vs. Monsanto, et at., six months.
Responsible for Realtime report1n1 of confldenJtal live proceedfnp, production
of transcript within 2.4 hours; upon judse's request, Immediate production of
excerpts for ruling.

2007 CART provider of Annual Deaf Nation Expo, Omaha, Nebraska.
2004-2008 Metropolitan Community College, Omaha, Nebraska. CART
provider for various level students, Including lectures, smaU IJ"DUP discussions.

Received Time Jun. 3. 2010 12:57PM No. 0158

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11748 P.OtS/014

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2004- Present Internal Revenue Service~ State of Florida. Transcription of
tape recordlnp made tn undercover operations.

2003-2004 Creighton University, School of Pharmacoloav, Omaha, Nebraska.
CART provider for web-based third-year pharmacolasy student.
2002-2003 crelpton University, Omaha, Nebraska •
CART Pravfder for on-campus undersraduate student- fall semester.

2002 CreJshton University School of Medlcfne, Omaha, Nebraska.
lead reporter of an aft.day hflhly confidential conference entitled: Ethics of
Study Deslan In Osteoporosis dlnli:al Trials. Produced transcript within one
hour of completion of conference.

2002 Thomas a Thomas Court Repo~ Omaha, Nebraska. lead caurt
reporter of deposition of Dr. cart camras with avemllht transcription.
2000 • Present lhomas a Thomas Court Reporters & Lepl Certified VIdeo,
UC, omaha, Nebraska. Verbatim reporting of depositions, Board of Mental
Health Hearlnp, Workers' compensation hearings, Nebraska Child Support
Hearlnp,JuvenUa Court Proceedlnp, realtime reportln& CART services.
1997-2000 Riverside Reporting Service, Memphis, Tennessee. Verbatim
reportlns of dvll depositions, civil trials, atmlnal trials In metrvpontan Memphis
area and the state of Arkansas.
May 1997 -July 1997 Precise Reporting Service, P.c., Chicago, Illinois.
Verbatim reporting of medical, technical and non-technical depositions.
Aprll1997 -July 1997- United states District Court for the Northern District of
JIUnofs. Verbatim reporting of Federal proceedings before the Honorable John F.
Grady. Assistant to Laura M. Brennan. Offtclal Reporter. ·

1995-1996 ·CART Provider for MBA student, Chlcaso, IIHnols.
1992 -1997 Cochran. Pudlo & Kozlawskl, Ltd., Chicago, IUfnols.
Realtime reporting and verbatim reporting of medical, technical and
nontechnical depositions, EEOC hearlnp, civil trials, realtfme reportlnc.
October 1991 -December 1991 Metropolitan Reporting. New Orleans,
t.oulsana. Verbatim reporting of medical, technical and non-technical
depositions.
July 1990 "":"February 1991 Sylvia Pastnno, P.c., New Orleans, louisiana.
V~rbatlm reporting of medical, technical and non-technical depositions.

Received Time Jun. 3. 2010 12:57PM No. 0158

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From:

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UCENSES/CERTIFTCAnoNS:
Nebraska, Certified Court Reporter· 2008- present ·
Iowa, Certified Shorthand Reporter- B/8/03
Arkansas Certified Court Reporter- 4/4/98
Tennessee- Notary Publlc-Ujg7
Certificate of Merlt,JC-5/B/03
Certlflcata or Merit, ur- S/7/94
Certificate of Merit, WKT -11/0/93

IUinofs.. Certified Shorthand Reporter-1/92
Offtclal Court Reporter Proficiency Examination, Illinois, 1/U/92
Louisiana Certified Shorthand Repoiter, 1990
National Court Reporters Association, 1990- present

AFFIUA110NS:

Nebraska Court Reporters Association, 2007 ·present
Iowa Court Reporters Assoclatlon, 2003 ·present
Illinois Court Raporten Association, 1992 -1997
National Court Reporters Association, 1990- present
Xscribe Users Assoclatlon, 199!1 -1996

VOLUNTEER WORK:

Hearfn1 Loss Association of America, Nebraska Chapter- CART Provider,
2007- present
Dundee Presbyterian Chun:h- CART Provider, 2009- present
St. Cecilia's Cilthedral School- Mending Mom, 2007- present
St. Cecilia's Cathedral- Parish Pastoral Council, 2009- present

~·

Received Time Jun. 3. 2010 12:57PM No. 0158

06/17/2010 14:28

am P. 0021oos

CART Repartq
Merpret '1\iSU a-ra..ey, RPR

My career as a court reporter bepn 'rn 1990 wben latlalned the national certJftcatlon of
ftealstentd Profeafonal RePorter throup the National Court Reporters ~Uon; In addftfon to a
wrtttan lcnDWIMfp exam, the sldlll teat c:onslstad ofthnesecttons of matertal.....,..ln~frona· ·
180 to 22Swords a m1n_uta. It Jswl!b, tlmtp, erperlence and opportunity that lsra.d~aU, ~a ·
rnltlme wrbt and subsequently a CART (Communfc:atlcm AccassRealllme 1'Dnllatlaft) pnwldar. As my
career inqhtmahm l.oulsfllne to m1no1s, Tennessee, Arbnsas, Nebraslra ..-~ow~, iwas prei..btcl
with new l1ld dlffanntopportunltles. It was In dUnolsthat I was first atven the~- prarVr.re
• CART to a deaf studentworfdns on his MIA.

T1la denwul tarCMT services has paWn over the yean u ledvlofoay has evolved and pined
aa:eptanceamona educatars, diSabAity semc:es caordlnaton and students With helrtna loss as a usaful
method fur partldpatlna fUlly In the classroom. It has bean my experience th8t studenll who do nDt use
Amartcan Sf8n
u their first lanau11• tand ta ftnd CARr a superior and more comrortabfe
·
method with Wldch to olstlfn tbe'niiCIIIIry educational material for them to reach their soaiL 1he
effecdwness of CARl' dapends peatly on the skiDs of t11e provider, the environment In which CART Is
provided and the abiHtv of Ill ...,Uu Involved. tram the administration to the student and the reporter,
to be able ta work tapthet.
·
..

a..,....

So what exactly Is CART? It Is a word-for-word speech-to-text lnterpretlns service far people .
with a heallna foss or others who would othcnllse benefit from this a~mod8tlan- for Instance,
people for whom En&lsh Is a
lanauase. Unlllce c:omputerlied note taldnc or abbft!Vfltlon . .
systems, which summarize Information fur the mnsumer, or Sh.\dent nora talcfns services, CARr provfdes
a complete traatkm of all spoken words as well as environmental sounds. 1hls enables the students
to decide for themselves what lnformatldn fs Important to them and no lonser be llmfted by the •
summarization of others.
·

seeond

Section i&.BOI(b)(l) aftha Americans wfth Dlsabmtles Act spec:lftcally recoplzes CART as an
asslstfVe tedlnotcJaythat affords effectiVe communication aceass.
How does It work? A CART provider uses a steno machine, notebook computer, and rultfme
software tD render Instant speech-to-text translation. 1he translation may appear, as In the Instance of
Michael Arsanyt, on a computer monitor that Is placed on the desk In front of him In such a way that he
can watch the professor, the Power Point or whatever else may be gDirq: on In~· front of the
ctusroom and have the translation within his staht. This particular way of settrna up the computer Is
very similar to the captions one may see on their personallV. You may ba watchlnc what Is 101a1 on In
the scene IJelns played on the screen, but simultaneously In your Bne of srcht you have the Enalfsh
translation as well.

leceiveJ Tiae Jun. 17. 2010 2:50PM No. 0186

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08/17/2010 14:30

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urn P. oostoo8

...("'

Several things take place In the environment that adds to the experience of communication. It
Is the CART provider's responsibility to convey as many of those .thlnp as possible. For Instance, a
statement spoken In a tonsue-ln-cheek maMer WbUid be translated verbatim With the added WOrd of
•sar~C'

as a parenthetical to convey the speaker's meanJng.

There are many benefits to CART. First, It Is flexible. It can be used on a one-on-one basis, In
smallsroups or even projected on a larse sc:reen for the benefit of an entire room of people.
CART promotes Independent leamlna. No longer Is a student dependent upon ~e notes of
another. He/she Is presented with all of the material the other students are and then allowed to choose
what they feel Is Important to take down as ncmts jUst the same as every student In the classroom.

-

In some settlnp students are ~ded the verbatim transcript of the class and then able to ·
review and htahlfsht what they deem necessary. In the case of Michael Arp~ he Is not provided a
transcript of the class anCI relies on the notes that he takes at the time ofthe leeture. There were a few
exceptions to this because of scheduling conflicts where I was physically unable io be In dass at the time
of the lecture. 1then provkled a tntnscrlpt from the podcast and provided It to hfm at a later date. This.
howe\ier, Is not an Ideal situation as there Is peat delay In the conveying of the lnformauon~ and It Is
always more difficult to transcribe from a recording rather than a ~lYe event.
CART promotes full participation. Because the translation Is In realtime, (with a second or two
delay), the student Is able to follow along In a discUssion and tJmely add comments and discussion. With
the added cue af environmental components and the mood of the speaker, the student can further
respond approprfatetv to the· setting.
AD of these things lead Into the sreatest benefit, equal access. The· student Is able to fully
understand what Is going on,lndudlngjokes, side comments, reaction of the dusmates and have a
broad and rich experience In the dassroom.
Tbe effectiveness of CART services depends a great deal on the &kills of the CART provider. The
National Court Reporters Association hai been certifying court reporters for mOre than 75 years, ind
NCRA has ret:ently dewloped a certification specifically for CART provl~ers. How can one deflne a
competent CART provider? The CART provider's manual sets forth various factors to consider In ·
addition to abUfty to wrfte.
First of all, there Is sensitivity. It Js Important In craat:Jns aood public relations that a reporter
knows how to effec:tively Interact wfth consumers and participants anl:l have an undemandlnl of the
role of sip lancuqe anf,l sign lansuase Interpreters. The CART provider has an wuferstandlr11 of Deaf
culture and realizes that CART or ASL may be preferred by Individuals dependlnJ on whether the person
Is Deaf, deaf, late-deafened or hard-of-hearing. Training acquired In communication techniques through
seminars, disability asencles and sfsn lansuase courses Is Imperative.

··Received Time Jun. 17. 2010 2:50PM No. 0186

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08/17/2010 14:30

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The CART proVIder must be able to stay fn the role of fadlltator of communication. Invitations
to partldpate In the proceeding outside of the role of CART provider should be politely dedlned.
Just as within the legal settln~ confidentiality and dlsaetfon are of utmost Importance at aU
times. The CART Pft!VIder should be aware that a casual comment made out of turn could betray the
confidences of a student or violate that person's ~tY·

keeping up with new technofosv, certlflcatfons, literature, and laws ralatfntr io CART services
enhances the provider's abDity to deliver the most up-to-date services possible.
·
Preparation Is paramount and sometimes one of the most difficult things to achieve. When
faced with a new CART asstgnment,.tl:ae reporter must rese;~rch and request all a"'-llable lnfonnitiOn
Pertinent to the subJect matter. Obtaining proper nouns,
of art, PDWI!r Pornt presentations, and
keynote speaker notes for a slven talk sreatJy Increases the ability Of a CART provider to translate with I
hlah deiree of accuracy.
·

terms

In the dassroom settfns, a CART provider must make every effort possible to ensure an accurate
Job dfctlonary far the termlnolosv to be used In each class. In the situation of the medical school
lectures, It was quickly determined that preparation would be necessary on a daUy basis. There are
often two to six hours of lecture a day, sometimes within two or three different classes. For Instance,
Evidence Based Medicine, Neuroscience lecture, and Neurvscfence lab was not an unusual combination
In the sprlncsemester of 2010. The termJnolosv daDv offered somethlns new Including scientific
formulas, Greek letters, and the use of super and subscript notations.
The medical school stUdents are provided, In most Instances In advance of the lecture, the
Power Point presenta~ons. They are then able to review In advance If desired. Since I was denied
access to the Power Point presentations In advance, and It was Imperative that preparation be done, I
was forwarded the lectures for the week vfa e-mail. I would. then print out the presentations and work
from the hard copy on burldlng a job dictionary In advance of the next day's lectures.
Once the job dlctlonary Is built, the CART provider Is expected to write "conflict-free." In other
words, homonyms and synonyms must ,_. dlstlnsulshed according to conteXt. Knowledae of grarimaar,
punctuation, sentence structure, high-frequency colloquialisms and slana Is crucial. The CART ptoVIder
must listen to content and be aware of continuity and sense to anticipate and prevent errors In
translation.
·
·
Understandfna and knowledge of the software and hardware InVolved Is lmpol'lilnt In order to
be able to troubleshoot and solve other technical problems. In order meet student preferences, one
must know how to change the appearance of the translation Jn terms of upper/lowercue, colored
backgrounds. etc. ·
·

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Received Time Jun. 17. 2010 2:50PM No. 0186

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nm P.oo&toos

The CART provider should abide by the National Court Reporters Assodatlon Code of Profeufonal Ethics
and should follow the General Guidelines for CART Provtdeq. And finally, the CART provider must
constantly be aware that the student Is relylns on the competence. of the reporter to aeate the best
possible chance of equal access. And just as the primary role of the realtime reporter in the classroom Is
to provide communication access, It Is communication between the CART provider, student, Instructor,
and coordinator of disability services that will prove crttfcal to the successful provfdlns of this service.

~~~~
r
Respectfully Submitted,

June 16, 2009
Marpretl'/Ska Heaney, RPR

References Andrews, J. {2000). Elfet:tlve Clllssroom Partldpatlon.
[Online] Avanable: bttD:Uqut.nqaonllae,qrqltelt/mtmlitls/snrln:ws,shcmt.

Arfa, R. (2000). HaVIng the Right calfls. [Online} Available:
htfp;Uqut.acrapnllnr:.tJIVIte:rtfmqn/alslarfa.shtmL
AUXIliary Aids and Services lor Postsecondaty students With Disabilities
(1998). Washington, D.c.: Depertment of EdUCIItlon Ofllce of avtl Rights.
[Online} Ava/labla:
ht:to;ttwww.e(/.qqWabqut/Q111a:stl15tJqWdqr;stauxa[ds.htmt.
.~

Battat; B. (l998). Teaching StUdents

Who Ate Hard-of-Hearing. Rochester,

N.Y.: Northeast Technlml Assistance Center, R.ocbf!JSI:er Instltul:s of
Technology. (Online} Available:
ht.trJ;Uwww.oetac.rlt.etlu/qubllcattoaltloshflf!t!test;btoqb.html.
Brentano, J., Larson, J., Werllnger, J., Hardeman, G., Gnrves, P.,
Eisenberg, s., Plleloger-St:hllt:t, K. (2000). RNitlme In the Educatlolllll
setting: Implementing New Technology lor Aa:ess and ADA Compliance.
Vienna, Va.: National Court Reportl!rs Foundation.
The CART Provider's Manual: A report of the NCRA Communication Access
Realtime Translation Task Force (200l). VIenna, Va.: National Court
Reporters Ass«<atlon. {Online] Available:
htfJ:u{lwww.qrrtlnfq.qmlmMuaf-html.

Received Time Jun. 17. 2010 2:50PM No. 0186

~

CART provider should abide by the National Court Reporters Association Code of Professional
hia and should follow the General Guidelines for CART Providers. And finally, the CART provide•
~constantly be aware that the student Is relying on the competence of the reporter to create t
,Josslble chance of equal access. And Just as the primary role of the realtime reporter in the
•~sroom Is to provide communication access, it Is communication between the CART provider,
Jdent, Instructor, and coordinator of disability services that will prove critical to the successful
oviding of this service.

tspectfully Submitted,
ne 16,2010
argaret Tyska Heaney, RPR

References Andrews, J. (2000). Effective Classroom Participation.
[Onli.ne] Available:
http: /lcart.ncraoqline.org /testimonials /andrews.shtml.
Arfa, R. (2000). Having the Right Cards. [Online] Available:

bttp; //cart.ncraonline.org /tgtlmonlals/arta.shtml.
Auxiliary Aids and Services for Postsecondary Students With
Disabilities {l998). Washington, D.C.: Department of Education
Office of Civil Rights. [Online] Available:
htto; //www.ed.qoy/aboyt/offlces/list/ocr/docs/auxalds.btml.
Battat, B. {1998}. Teaching Students Who Are Hard-of-Hearing.
Rochester, N.Y.: Northeast Technical Assistance Center, Rochester
Institute of Technology. [Online] Available:
http://www.netac.dt.edu/publicatlon/tipsheet/teachinqb.html.
Brentano, J., Larson, J., Werlinger, J., Hardeman, G., Graves, P.,
Eisenberg, s., Pflelnger-Schact, K. (2000). Realtime in the
Educational Setting: Implementing New Technologv for Access and

ADA Compliance. Vienna, Va.: National Court Reporters
Foundation.
The CART Provider's Manual: A report of the NCRA Communication
Access Realtime Translatinn Ta!l;k Fnr,..,. t?nn1' \11-~--- u ... •

08/17/2010 14:30

· From:

1m P. 008/DDB

.~

Commimfcatlon Access Information Cente.: National Colflt Rerpoters
Assodat/on. (Online] AvaUable:
http:!(www.qut:lnfg.OI]l
Gfnsburg, c. (2000). Performing Your Best: With CART. [Online] Available:
http:llc;ut.nqagnlln&qrg/Catlmonfalflqlrubwp.sbtml.
Hartley, P. (2000). ~Simply Fair. [Online] Available:
bt(p:Uqyt.nqaooi/Of!.otglt.asUmqnfals/hacctey.shbiJI.

How tD Locate a CART Provider (20DJ).

[Online] Available:
bttR:UCIJrt.nt:MQnUoe.qr:plmiWJmerllgca&pt;.shCmJ.

Nelson, A. (2000). Getting Everything. {Online} Available:

trq;p:!lqrt.nqapnUae.qcpJtestlmoalalsfnelsrm.shtpll.

.

.

Stinson, M., Elsenb,erg, s., Hom, c., I.JJI'$01J, J., Lsvttt, H., Stuckless,. R.
(1999). Real-71ms Speech-to-TfiJtt Semces: A rePo!t of the Natlon'IJI Taslc
Force on Qua/Tt:y of Se(v(c:es In the l'ostsecondaty Education of DtJafand .
Hald-of·Heartng Students. RochestBr, N.Y.: Northeast Technical Assistance
Center, RocheSter 1Mtltut8 of Technology•

........................

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Received Time Jun. 17. 2010 2:50PM No. 0186

Q

~ianne DeLair
Mydge [e-mail])
Thursday, June 17, 2010 3:21 PM

rrom:
Sent:

To:

Dianne Delair

Addendum to Report

Subject:
Dear Dianne,

As an addendum to my report, I would like to state that I have never provided prior expert testimony and do not
have any publications.

Respectfully submitted
June 16; 2010
Margaret Tyska Heaney, RPR

1

\D

MARGARET TYSKA HEANEY, RPR
FEE SCHEDULE/INVOICE

June 1,2010

$95/hour- testimony
$45/hour- preparation

**********************************
Preparation - 5/28/10- 5/30/10
3 hours

Total Charges

$135.00

$135.00

\\

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CART Reporting
OEF!NmON
CART reporting Is a version of the captioning process called Communication Access Realtime
Translation, also known as live-event captioning. It allows court reporters to provide more personalized
services for deaf and hard-of-hearing people. CART providers accompany the cflent as needed- for
example, to college dasses- to ·provide an Instant conversion of speech Into text using the stenotype
machine linked to a laptop computer. (ncraonline.or& careers In Court Reporting, captioning and CART
-An Introduction.)
ACcordlns to the National Court Reporters Association, a CART prOvider must possess the
knowfedp and procedures apphcable to the spedflc realtime environment. Knowledse of available
hardware and $0ftware as well as equipment set up and room layout.
·
It Is .Important I~ creating good public relations that a reporter knows how to effectively Interact
with consumers and partfdpants and have an understanding of the role of sign language and sign
language Interpreters. Education of Deaf culture and diversity and sensitivity Issues.&•
A CART reporter must abide by the NCRA's Guidelines for Professional PraCtice and the Code of
Professional Ethics. Familiarity with the CART Provider's Manual Is Important as well.
EDUCATION AND TRAINING
A CART provider Is a highly trained professional who possesses the advanced skills
required to Impartially, effectively, and accurately perform realtime translation.
There are several professional certifications a CART provider might have. The first Is
RPR, or Registered Professional Reporter. This Is the basic level of certification required
for court reporting and Is the first step In learning the advanced skills necessary to become
a CART provider. RPRs have achieved writing ac~racy at 225 wpm. Obtaining the CRR,
or Certified Realtime Reporter, designation demonstrates a proficiency In realtime
translation. A Certified CART Provider, or CCP, possesses the knowledge, skill, and
ability to produce complete, accurate, simultaneous translation and display of live
proceedings utilizing computer-aided translation In a fiVe event setting at speeds exceedlnc
180wpm.
A CART provider must also be sensitive to the varying needs of consumers and has had
training In conveying a speaker's message, complete with environmental cues.
The Americans with Disabilities Act specifically recognizes CART as an asslstlve
technology which affords "effective communication access. • Communication access more
aptly describes a CART provider's role and distinguishes CART from realtime reporting In
a tradltlonallftlgatlon setting.

\~

Communications Access Information Center - Cart In The Classroom

·,CART -'io ;the -;C'Ja$sroom·:
:He-w to :Moke ;i(-e.,~Jiime
Copti.oning :work f¢r You

How to Locate a CART
Provider·

What to Expect From a
CART Provider

Page 1 of 1

What Are the Benefits of CART in the Classroom?

CART In the Qamoom
Meeting the

Communication Needs of
QJI!dnm In School
Meeting the

Communication Needs of
Postacondarv Students

The following paper, CABT In the Qassroom; How to Make Realtime
captioning work for You, presented at the Instructional Technology and
Education of the Deaf symposium at the National Technical Institute for
the Deaf In June 2001, explains the benefits of CART for students who are
deaf, hard-of-hearing, late-deafened, oral deaf, or have cochlear
Implants. The paper also discusses how CART providers can work
effectively with Instructors and coordinators of services to ensure that
students wlth hearing loss receive the best communication access
possible.

Deaf. HatJI-of-Hear1ng
Resources

Communication Access In
the Courts

CART legal Dedsions

Researcher Aaron Steinfeld wrote his dissertation on the benefits of
captions In the classroom setting. When he presented this Information at
a convention of the Alexander Graham Bell Association for the Deaf and
Hard of Hearing (AG Bell), he was Inundated with requests on the studies
he used as a starting point. He has allowed us to reprint this essay, In
which he lists a number or those references, for the use or people who
are petitioning for the use of CART In the dassroom.

Benefits of CART

CART Environments
Plg!tal Hearing Ajds

CAIC Home

C 2002 National Court Reporters Assodalion, All Rights RI!$Cirved

NCRFHome

NCAA Home

.___./

http://www.cart-info.org/classroom.html

5/30/2010

\~

General Guidelines for Communication
Access Realtime Translation (CART)
Providers in a Nonlegal Setting
ACommunication Access Realtime Translation (CART) provider In a nonlegal setting performs realtime
translation as an aid to communication for people who are deaf or hard-of-hearing. Common sense and
professional courtesy should guide the Member In applying the f9llowlng Guidelines. When providing
CART In th~ legal setting, follow the guidelines set out In the section above.
In providing CART service, a Member should:
A. Accept assignments using discretion with regard to skill, setting, and the consumers involved,

and accurately represent the provider's qualifications for CART.
B. Establish a clear unde~ndlng of:
1. who Is hiring the CART provider;
2. whether an electronic file of the roughly edited text with disclaimer Is to be preserved;
3. If yes, whether all participants have been Informed that an electronic file of the roughly
edited teXt with disclaimer will be preserved; and
4. who Is entitled to receive a copy of the electronic file.
C. Acquire, when possible, Information or materials In advance to prepare a job dictionary.
D. Know the software and hardware system used and be able to do simple troubleshooting.
E. Strive to achieve, as nearly verbatim as possible, 100% accuracy at all times.
F. Include In the realtime display the Identification, content, and spirit of the speaker# as well as
environmental sounds.
G. Refrain from counseling, advising, or Interjecting personal opinions except as required to
accomplish the task at hand.
H. Cooperate with all parties to ensure that effective communication Is taking place.
I. In confidential nonlegal settings (i.e., medical discussions, support groups), delete all files
Immediately after the assignment unless otherwise requested not to do so.
J. Preserve the privacy of a consumer's personal Information.
K. Familiarize oneself with the provisions of NCRA's "The CART Provider's Manual," these
Guidelines, and any updates thereto.
L Keep abreast of current trends, laws, literature, and technological advances relating to CART.

0 2002 National Court Repotters Assaclatlon, All Rights Res8MJCI

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NCRA COPE OF PROFESSIONAL ETHIC$

The mandatory Code of Professional Ethfcs defines the ethical relationship the public:, the bench, and
the bar have a rlsht to expect from a Member.. The Code sets out the. conduct of the Member when
deaRng with the user of report1n1 services and acquaints the user, as well as the Member, with
suldeltnes established for professional behavior. The Guidelines for Professional Pl'llctfce, on the other
hand, are goals which every Member should striVe to attain and maintain. Members are ursed to
comply with the Guidelines and must a'dhere to local, state and federal rules and statutes. It should be
noted that these pldelfnes do not exhaust the moral and ethical considerations with which the Member ·
should conform, but provide the framework for the practlce of reportl"'-. Not every situation a Member
may encounter can be foreseen, but a Member should always adhere to fundamental ethical prlncfples.
By complyfns wJth the Code of Professional Ethics and GuldeRnes for Professional Practice, Members
maintain their profession at the hllhest level.

A Member Shall:
1. Be fair and Impartial toward each participant' In all aspects of reported proceedfnp, and always
offer to provide comparable services to all parties In a proceedlns.
2. Be alert to situations that are conflicts of Interest or that may give the appearance of a conflict
of IntereSt. If a conflict ~r a potential conflfct arises, the Member shall disclose that co~ftk:t or
potential conflict.
3. Guard aplnst not only the fact but the appearance of Impropriety.
4. Preserve the confidentiality and ensure the security Of Information, oral or written, entrusted to
the Member by a.nv of the parties In a proceeding.
s. Be truthful and accurate when maklns public statements or when advertblng the Member's
qualifications or the services provided.
&. Refrain, as an official reporter, from freelance reportfns actMtfes that Interfere with official

duties and obllptlons.
7. Determine fees Independently, except when established by statute or court order, entering Into
no unlawful agreements with other reporters on the fees to any wer.
·

8. Refrain from stvlni, directly or Indirectly, any sift, lncenttve, reward or anythlns of value to

attorneys, clients, witnesses, Insurance companies or any other penons or entttles associated
with the llt!Catlon, or to the representatives or apnts of any of the fDresofn& except for (1)
Items that do not exceed $10D In the asiJ'1!Pte per recipient each year, or, (2) pro bono services
as defined by the NCAA Guidelines for Professional Practice or by applicable state and local laws,
111les and resulatlons.
9. Maintain the fntesrltv of the reportlnl profession.

10. Abide by the NCRA Constitution & Bylaws.

Received Ti11e Jun. 3. 2010 !2:57PM No. 0158

J/1!11»..

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CART in the Cl.assroom:
How to Make Realtime
Captioning Work for You
Introduction
Communication Access Realtime Translation (CART) Is a word-for-word
speech-to-text Interpreting service for people with a hearing loss or who
would otherwise benefit from this accommodation. Unlike computerized
notetaklng or abbreviation systems, which summarize Information for the
consumer, CART provides a complete translation of all spoken words and
environmental sounds, empowering consumers to dedde for themselves
what Information Is Important to them. Section 36.303(b)(1) of the
Americans with Disabilities Act spedflcally recognizes CAR.T as an
asslstlve technology that affords effective communication access.

A CART provider uses a steno machine, notebQOk computer, and realtime
software to render Instant speech-to-text translation on a computer
monitor or other display for the benefit of an Individual consumer or
larger group In a number of settings: dassrooms; business, government,
and educational fUnctions; courtrooms; and religious, dvlc, cultural,
recreation, and entertainment events. In addition, a CART proVIder Is
sensitive to the varying needs of consumers and has had training In
conveying a speaker's message, complete with environmental cues.
The demand for CART has grown at a steady pace In recent years In
almost all arenas. However, the greatest growth has taken place In the
educational setting, from elementary to graduate school, as this
technology has gained greater notoriety among educators, disability
services coordinators, and students with hearing loss as a useful method
for partldpatlng fully In the dassroom. Several key factors play a role In
determining the effectiveness of this service: the competence of the CART
provider, the environment In which CART Is provided, and the ability of
the CART provider, student, Instructor, and coordinator of services to
work together.

CART Benefits

In the 1999 paper •Real-Time Speech-to-Text Services," the authors,
members of the National Task Force on Quality of Services In the
Postsecondary Education of Deaf and Hard-of-Hearing Students,
referenced a 1988 study at the Rochester Institute of Technology of
students who are deaf and hard-of-hearing. When survf!yed about CART,
the students responded favorably. The authors state that •A majority of
the students reported that they understood more from the steno-based
text display than from Interpreting" (Stinson et al., 1999, p. 12).

_j

\ls,

The Task Force noted several other advantages to the steno-based CART
system: 1) CART provides a verbatim record of the class, capturing every
word spoken; 2) a single CART provider can cover a two-hour class with a
brief break; and 3) the stano machine Is silent (Stinson et at., 1999, p.
21). Because CART gives students with hearing Joss a complete record of
what Is said In the classroom, sev~l other advantages to this
communication acx:ess tool become readily apparent:

Flexibility. CART can be used In a variety of seWngs, whether one-onone with a single student reading off of the CART provlder*s laptop
computer saeen, In a small group with the text appearing on a television
monitor, or even In a much larger setting with the CART provider's
realtime text projected to a farge screen for everyone In the lecture to
read.

Independent learning. With the provision of CART, the responsibility
for a student's education rests with the student. Rather than relying on
notes provided by others, the student will have a verbatim record of the

dass or discUSsion from which to darmlne what Is or Is not ·Important
based upon the student's understandfng.of the material presented. In
addition, students can have the text file fed through a version of
litigation-support software as the CART provider realtlmes the dass. l1le
student can then use the highlight or annotate features of the software to
pick out what he or she wants to retain. Thus, the student has the Choice
ot obtaining the verbatim record of the dass or only those portions that
he or She deems Important. AS Rachel Arfa (2000), who used CART as an
undergraduate at the University of Michigan, explains, •with realtime
captioning,. I was able to form my own optnfons of the subject matter and
receive the Information firsthand, rather than second, thfrd or fourth
hand, since CART takes every sentence that Is belng said.•
Full partldpation. Because the provision of CART services Is In real
time, the student with hearing loss has the opportunity to participate tn a
classroom setting just Uke any other student. Andy Nelson (2000), who
used CART at the University of Washington, says, •Realtime captioning
allowed me to get everything the professor says In dass, word for word,
as well as comments or questions students have during the leCture. This
enabled me to actively partfdpate In discussions and lectures, something
I had never ever been able to do before. • Joan Andrews (2000), a CART
consumer while In college, offers another example: "Realtime
professionals also can Include brief descriptions that provide Information
about the mood of the person speafclng - exdted, despalrlng, angry,
heated, placating; signals that the hearing students access easUy and
which often guide them In choosing their responses to the dialogue taking
place. These bits of Information play a vital role In effec::tlve dassroom
partiCipation. •

,,

.r
Equal access. "CART aUowed me tot the ftrst time In my entire academic
·
career to follow classroom discussions, parttcfpate In dassroom
discussions, and take my own notes," says carolyn Ginsburg (2000), who
used CART while eamlng her MBA from Columbia University. 'What an
Incredible experience this was. It was very liberating, made me finally
feel equal to my peers In the classroom, gave me equal access to
Information, and gave me more confidence to express my opinions and
answers.• Paul Hartley (2000), currently a student at Emory University,
offers a similar opinion: "Being at the same. level as any other student Is
the major and most important benefit of CART. Servl~. I get the same
Information, hear the same lectures verbatim, feel more a part of the
dass, and hear Interesting anecdotes or a professor's mmy jokes. •
The provision or CART services also offers some benefits to the Instructor.
For example, verbatim lectures may give the mllege professor an
additional tool for preparing tests or ln~ratlng lnfonnatlon Into a
research stUdy. Further, "Some Instructors welcome the transcripts as a
way of tightening their fectu. . and reviewing their students" questions
and comments. If the Instructor chooses, he or she should be at liberty to
share them with hearing members of the dass also. The transcripts can
be of·value also In tutoring deaf and hard-of-hearing students, enabUng
tutors to o~nlze tutoring sessions In dose accord with course COI)tent"
(Stinson et al., 1999, p. 7-8).
The Competent CART Provider
The utility of CART services for the student with hearing loss depends a
great deal on the skills of the CART proVIder. The National Court
Reporters Association has been certifying court reporters for more than
75 years, and NCRA Is rurrently developing a certification speclftcally for
CART providers. UntR this objective measure of the CART provlder"s
ability Is In place, how can you define a competent CART provider?

NCRA's CART Task Force considers the Registered Professional Reporter
(RPR) a requisite for a qualified CART provider. The RPR certifies the
entry-level reporter's ability to provide a verbatim record at speeds
ranging from 180-225 words per minute with a minimum accuracy of 95
percent ("How to Locate, • 2001). The Task Force also recommends the
attainment of the Certified Realtime Reporter designation. The CRR has
proven his or her ability to write realtime at variable speeds ranging from
180-200 words per minute with a minimum aca.aracy of 96 percent. The
CART Provider's Manual (2001), published by NCRA, ofl'ers some
additional factors to consider:
·

Sensitivity. The CART provider has general knowledge about Deaf
culture and understands that the prererred communication mode of a
person with hearing loss differs depending on whether the Individual
Identifies him or herself 's Deaf, dear, late-dearened, or hard-of-hearing.
A CART provider aatulres training In communication techniques through
court reporting assodatlon seminars, disability agencies, sign language
courses, etc.

r-'
.J

..1""
'
Staying in role. The CART provider's role Is to fadlltate communication.
A CART provider dedlnes any Invitation or suggestion to comment,
Interject, advise, respond to Inquiries, or In ariy way become Involved In
the proceedings outside the role of CART provider.
Confldentfallty. COurtesy and discretion are required of the CART
provider at all times. A casual word or action may betray a consumer's
confidences or violate a client's privacy.
Professional development. The CART provider keeps abreast of current

trends, laws, literature, and technological advances relating to the
provision of CART service.

Preparation. The CART provider must make every effort to ensure an
aCOJrate job dictionary for the terminology to be used In each dass.
Realtime writing. The CART provider writes conflict free, Includes
punctuation, and sustains accuracy for long periods of time.
Software/computer knowledge. The CART proVIder must operate a
computer-aided transcription program and understand Its realtime
translation and display functions. The competent CART provider knows
how to troubleshoot and solve hardware, software, and other technical
problems. In order to meet consumer prererences, the CART provider
must know how to activate upper/lowercase,· colored backgrounds,
enlarged text, and other display options. When appropriate, the CART
provider must be able to furnish the computer ftle of the session text as
requested.
Language comprehension. Knowledge of grammar, punctuation,
sentence structure, spelling, vocabulary, high-frequency colloquialisms,
and slang fs audal. The CART proVider must listen for continuity, sense,
and detail of proceedings, antldpatlng and preventing errors in
transtatlon.

CART Environments

CART services can prove effective In almost any educational environment,
from grade school to graduate school. In particular, "Today, steno·based
systems rank as an effective support service for large numbers of deaf
and hard-of-hearing students In mainstream college environments
throughout the country• (Stinson et al., 1999, p. S).
Why is the steno-based CART system gaining popularity? Much of It goes
back to the comments rrom CART consumers regarding Independent
learning, full partldpatlon, and equal access. As noted In •Auxiliary Aids
and Services for Postsecondary Students With Disabilities, .. published by
the Department of Justice's Office of Ovll Rights (1998), schools not only
must provide auxiliary aids and services In a timely manner, but they
must ensure that students with disabilities can partldpate effectively. And
the definition for effectiveness? •No aid or service will be useful unless It
is successful In equalizing the opportunity for a partlaJiar student with a
disability to partldpate In the education program or activity."

Keep In mind, however, that generally CART consumers are IndiVIduals
who have developed a hearing loss postllngually, or rather alter the
aCI~ulsltion of language. In addition, there Is no set age at which a child
can begin to make use of this service: •AJways remember that each
Individual case Is unique-- there are no hard-and-fast rules on the age
level of a student fOr which realtime translation Is suited" (Brentano et
al., 2000, p. 22).
·
Before Implementing CART In an educational environment, the most
Important consideration, of course, Is the student's preference regarding
a method fOr communication acress. Other factors are prior experience
and satisfaction with realtime speech-to-text translation In the dassroom,
the student's ability or wQIIngness to partldpate In discussions and to ask
questions, and the level of reading proficiency (Stinson et al., 1999, p.
23).
Working Together

The success of CART In the classroom setting depends not only on the
provlder"s skill level, but also on the abHity of the CART provider to work
efl'ectlvely with Instructors and the coonUnator of services to ensure that
the student with hearing loss rece~ the best service possible. Following
are several considerations that can help to ensure an effective working
arrangement to the beneftt of the student with hearing loss:
Control of the classroom. The CART provider Is In the classroom with
the sole purpose of providing communication access lbr the student who
Is hard-of-hearing. To ensure an effective realtime translation, students
should speak one at a time. •Noisy• conditions can have an adverse errect
on the production of accurate text by the CART provider (Stinson et al.,
1999, p 9). The responsibility for controlling the dassroom lies with the
Instructor, who must maintain an orderly discussion to allow for
partldpatlon by the CART consumer. The Instructor may need to restate a
student's comments to ensure understanding.
Preparation. "The reporter wiD work with the Instructor for each
assigned dass to assure that all the technical terminology for that
particular class will be provided In advance so that It can be entered Into
the reporter's computer diCtionary" (Brentano et al., 2000, p. 9). This
preparation, with the Instructor's assistance, allows for a more accurate
translation or the spoken word. 1lle CART provider should receJve copies
of all textbooks and other class materials l'rom which to prepare.
If possible, this preparation also lndudes a meeting between the CART
provider, student, Instructor, and coordinator of services before the start
of the school year. At this time all Involved parties can ask questions
regarding requirements or mnoems. In addition, "This will allow the
reporter an opportunity to view the dassroom's physical setup and to
work out with the disability coordinator, Instructor, and student the best
seating and sight lines available for all concerned" (Brentano et al., 2000,

p. 22).

I

r
Laying out the ground rules. Discuss during the orientation meeting
what will be expected or the CART provider. What classes will require
CARn How long are the dasses? Will the CART provider be following the
student to different dassrooms? Who Is entitled to reeelve a c:opy of the
notes? What form will the notes for a class take: paper or disk? When wllf
the student receive the notes? Will the CART proVIder have time to edit
the notes? WOI the Instructor also receive a copy of the dass notes?
How will the CAR.T provider contact the Instructor or disability services
coordinator or vfce versa? For example, "If a teacher or professor Is
caooeUno dass or Is giving a test for which the reporter's services are not
required, sufftdent notice should be given If for nothing other than
common courb!sy" (Brentano et at., 2000, p. 25). A poUcy should also be
estabUshed for when the student Is unable to attend dass.

Think communication. When possible, the Instructor should write
aMouooements, assignments, ·proper names, technical vocabulary,
formulas, equations, and foreign b!rms on the blackboard (Battat, 1998).
In addition, the Instructor should not "talk to the blackboard" and have
his or her back turned to the class all the time. And when· using
overheads or referencing materfaf.on the blackboard, the Instructor
should be spedftc when explaining concepts, ronnulas, or equations. For
. example, In a math dass rather than pointing to the blackboard and
saying, "You add this and thJs and get that," the Instructor Should say,
"You add 5 and 4 and you get ~· •
Just as the primary role of the realtime reporter In the dassroom Is to
provide communication access, It Is communication between the CART
provider, student, Instructor, and coordinator of disability services that
will prove aft:lcal to the successful provision of this service.
•

References Andrews, J. (2000). Effectfve Oassroom Partldpatlon.
[OnUne] Available: htlp:ljmrt.nqaonllne.org/testlmgnlalslandrews.shtml.
Rfgh~ cards. [Online] Available:
bttp:ljqrt.nqaonDne.omftestlmoolals/arfa.shtm!.

Arfa, R. (2000). Having the

Auxiliary Aids and Services for Postsecondary Stud_ents With Disabilities
(1998). Washington, D.C.: Department of Education Offtce of Cvll Rights.
[Online] Available:
htt,p:/Jwww.ed.gov/abouttomcesnlstJpqldqcs/auxald5.hb'OI.

Battat, B. (1998). Teaching Students Who Are Hard-of-Hearing.
Roc:hester, N.Y.: Northeast Technical Assistance Center, Rochester
Institute of Technology. [Online] Available:
http:/fwww.netac.rft.edy/gub!Jcatlonltlpsbe&tlteacblngb.html.
Brentano,J., Larson, l., Wer11nger, J., Hardeman, G., Graves, P.,
Eisenberg, 5., Pflelnger-Schact, K. (2000). Realtime In the Educational
Setting: Implementing New Technology for Access and ADA Compliance.
VIenna, va.: National Court Reporters Foundation.
Jhe CART Provider's Manual: A report or the NCAA Communication Access .
Realtime Translation Task Force (2001). VIenna, Va.: National Court
Reporters Association. [Online] Available:
htto: l/www.carUnro.om/manual.html.

Ginsburg, C. (2000). Performing Your Best With CART. [Online] Available:

bttp:Ucart.ncraool!na.om/testlmOolals/gl05bum·sbtml.
Hartley, P. (2000).lt's Simply Fair. [Online] AvaUabfe:

http:llgut.nqaon!lne.orgJtestlmontals/barttey.sbhnl.
How to Locate a CART Provider (2001). [Online] Available:
htt;p:/lcart.naaonltne.org/cgnsumer11ocator.shtml.

Nelson, A. (2000). Getting Everything. [Online] Available:
http: Ucart.oaaonQoe.org/testlmonlals/nelson.sbtml.

Stinson, M., Bsenberg, S., Hom, c., Larson, J., Levitt, H., Stuckless, R.
(1999). Real-llme S~ch-to-Text Services: A report of the National Task
Force. on Quality of Services In the Postsecondary Education of Deaf and
Hard-of-Hearing Students. Rochester, N.Y.: Northeast Technical
Assistance center, Rochester Institute of Technology.

Lecture#86

Central Pontine Myelinolysis
"-~~ A~~!''l"."f."il:~~';'·~~"''!"''!!''~o-··
......

• Progressive spastic

......gLliltdRms and lower litt:l»

1

1:\
~.,~

'':~

cranial nervtR~Is!!!!
• Discolored area in
central basis pons
• Results from too rapid
correct.lon of

hyponatrem~serum

hY.J>O-OSmofiififY
·--- .....__ .......
•

I-IOk"~

I

Central Pontine Myelinolysis
•. Q!.rnl!@!i.n_ated area
ln'basis pOiiSWlif,

~~:

~~·

preserved axons and · :.·.. ·
~ti
pontine neurons

...

·

.:

·-~~!l~ll!lQHJLQil
• lnlllal drunkenness, headache, abdominal
pain, and visual loss, evolving into delirium
and coma
• Methanol converted by hepatic alcohol

_
c!e_~a~g-~~ in~ fo~lOellyHb"and

fo{!l!~c acid resulting In sevenHiiB'tabolic
acl~18 -

LFB-PAS Stain for M~li_n

1

Lecture#66

• ·iiljUryb;putamen restJIISI•
ln extrapYtilflldll

movementaiSOrdets

DE4$f~vr

o Bc.,s / ,_ ~:- ·u r&.)

'

'

k'o~s /KoF

(
Wernicke-Ko lsakoff Syndrome
• Wernicke diseas t (encephalopathy)
-Abrupt onset o~Jlllal and lateml
!!!~W progressing to external

• -~ttt~_o£!~.

..:-Jnmgsland galt ataxia
-Global confuSion~staie

2

Lecture#66

.-!""'

Wernicke Disease

Wernicke- Korsakoff Syndrome
• Korsakoff's ~chosls
- AnW5Jrade amnesia -Inability to fonn
• new memories despite Intact Immediate
reeall and remote memory
• ~f,hnlai!Qo- falsHing memories by
"tiffing In• gaps In memory with Information
that sounds plausible but has IIWe basis ln

reality

Korsakoff's Psychosis
• Bilateral neuronal loss and gliosis of
~2if2-~ thalamus ancUnamm.lll~~'Y.

res

·-

e!J!!gganesi! of Wernicke..·
KorsakoffSyndrome
• Th!.!!IDiDI..Is cofactor for transke~! and
~4 enzymes=:;
~ifi~ase compl ~ha­

-""fam5§ibfil'fifi Bahydrogenase)
~ Triimealafetreatment with high-dose parenteral
thtwne during BBI(y'Wemlcke disease

·PrOcJuces rapid d!llmatic improvement

• Neuronal death follows delay In thiamine
administration resulting in Korsakofrs
psychosis

--

3

lecture#66

Alcoholic Cerebellar Degene tion
• !."!.flE~Iand gait ataxia
f)
vermis and a(fjacent anteriorlOl;e"-

• Shrinkage of folia of superior (ros
.

··----.

~M!!£t!!XJ!g/!R.'l!nD
• Adults - personality disturbance and dementia
(use of mercury In felt hat production resulted In
descriptive ptu"as8; "maaas a hatterj, cerebellar
atalda,lntentlon tremor, and motor neuropathy

Fura uaed ro mako~
felt hala wero dipped In

mercwy nllrale eo1ut1on
aa a preaervadve and
to BOlten lhe enlmal halta.

Mercury poisoning
• Children- acrodynia (Pink
disease): sWOleil:'ii<r. cold,
moist hands and feel
lrritabiQty,lnsomnla, and
anorexia

• OrganTc mercury can cross
placenta causing mental
retardation or cerebral palsy

.

• Epidemics of mercury poisoning from eating

treated seed grains.

- u.s. wheat seed grain treef8d with

m~~ compounds as a~

B

have
b'Rifplanted, but Instead was sold for miiDng ancs
made Into bread (despite being dyed red as a
warning and having wamlng labels In English and
Spanish (which most people aMid not read In the
M\d<De Sill and NlQD
:~arty large epidemics In I~ In 1956, 1960.
1971 and .P..aklslis{lln 1961 ,......._

4

Lecture#66

• Peripheral--and ataxia
(mimicking

degeneration),

oph1hai!DQPioglf, and P!A!:DenJirl

retinopalh! •
• A9soclatedwlth chrun(e.maiJbso!E.Ifon

syndromes

kA-bEU /SHAl>l)..
kA-aatfs~

VItamin E (Alpha-tocopherol) Deficiency
• Demyelination of spinal cord posterior
columns
• Axonal enlargements containing
~.membranes, abnormal
mitochondria, and granular material

• Pernicious anemia

·~combined

degeneration of spinal cord
• Combined systems disease

• ~aiVe-r;;wscin pigmentation or
neurons.~ and muscle cella
..... _. ___

.._

5

c?l

Lecture#66

VItamin 8 12 Deflci
• Loss of poslerfor column sensation ~:
vibratory and po&ltion sense)
- Poslllw ~test
• Spasllclly ~raJ extansor plantar responses
~ rellex8&) and Joss of tendon reflexes
-~~: m&nory disturbance, and dementia

• Elevated levels of ~~l~~~~ acid in
serum or urine

• Low serum vitamin B12 levels

.......

• Positive SchiUing test
• Anemia (megaloblastic anemia), ·
macrocytblli, tst
~

iiPPersBtJft'iSOted

Remt6pHlls

Vitamin 8 12 Deficiency

.................i~i~O§L~
.

· GM2
............. ..._.,.,-gan

• Prototype autosomal recessivqJ!P.iGQ!!:;
~!!!!'I storage disease

••
- lnvolvemontof anlarior,
poetericf, and lalonll
columna, cantered in
mld-lhotacie opinal told

-Deficiency of lysosomeJ_m,~~IJI.I~Id!';Se
activity

• Deficiency of hexosaminidase A

:- ~~-~h8.Pl~~e

-Late-onset Guz-gangllosidosls

• Deficiency of hexosaminidase A and B
-Sane:!!'~'!" d~f!S.8
lfB..PAS Stain for Myolin

6
._/I

Lecture#66

Pathology of Tay-Sachs Disease

Tay-Sachs Disease
...

~~~ ~~--

lniUal brain enlargement followed later by marked
cerebral alrophy
• Ballooned neurons containing enlarged lysosomes
•• YiiiR gnin*tdar and lameUar sRD=e material
o

..-..,

--- ..

Neuronal Ceroid Upofuscinosis
o

Group of disorders presenting from Infancy
to adulthood characterized by:
-Autosomal recessive Inheritance
-Progressive cognitive deterioration
-Seizures
- Retinal abnonnalilies (pigmentary retinopathy)
~~~~- .. .o#~.rr-··6· .--.,. .. · •..•

• ~rBr~material (ceroid
in lysosomes of
multiple organs:

• )OlitCJrr

- Macrophages In spleen, liver, and lymph

nodes
- Smooth muscle cells of gastrolntesUnal
trac~ ~and arteries

- S
-

taT.mcrc:ardlac muscle
al ~and tubules

- eurons Ofbiiiin ancfmrn-;

7

Lecture#66

·~brain
• Ceroid ll~n neurons

..

• Curvilinear bodies

• Accumulation of sulfaJJde
(galactocerebros'ffi:'su"ate)
• ~eijcrencyof enzyme arylsulfatase A which
normally cleaves stfiiifi'&Ti sulfai1d8

..__..

Metachromatic Leukodystrophy . ·

=

•·· J.!IJ.
yeat&

Pf001'11881ve gait ciaturbance by age 2

r:=Ld byJniiiSljnatablllty, vlaualloaa (optic

periphoral ~thy, =e~:e; falal aftor

~-~ galtdiatwbanr:e lind dlmlnlahed
PemxmiUICit about age 8 yeant foiiGWIId by

apaaliclty, peripheral nauropalfly. visual 1oM, quadriplagla,
and death by laiD adola.cenca
.~-~- inaidiou8 onaetln lata edolaac:enc:e or early
adulthood of .JaMy progrenN. gait lhtutbance.
behavioral problema, apullc:lty. and parlphenll neuropathy

. .

etachromatic Leukodystrophy
• cavltab!d while maHer
(sparing of U-fibers)
• Loss of otrgodendrocytes
and Schwann cells and
myelin
• Granular masses of
accumulated sulfaHde In
macrophagcs

8

Lecture#66

~eroxisomal Disorders

Adrenoleukodystrophy and
Adrenomyeloneuropathy
• Spastlq.qapma~ls and sensory loss
• Impaired bladder function
• Adrenal Insufficiency

• Symmetrical dem.;!lnation of cerebral white
mattar, most 810 &TUI!'Efpftal regions

• low serum,')!' levels
• Penpheral neuro athy

9

J\

Lecture#66

10

. ·.

Business
and justice

You always knew that your brain was wor·k_inq llar d Ht :n · l)
a scientific discussion of tile brain of a court u;porter
eted. The person must receive, comprehend, synthesize, and
translate lnformaUon Instantaneously through a network of
complicated brain mechanisms.
This Is all done seemingly effortJessly. but when examining
the skills necessary. the data argues for the great value of coun
reporters. This examlnaUon of the brain mechanisms also provides a more exact determination of the skJJis necessary. only
capable by the amazing human brain.
Th better understand what is involved, following Is a brief
descrlpUon or the major brilln functions as now understood,
necessary for not only many dally human tasks, but especially
for the high-level functioning Involved In court reporting.

Court reporters perfonn a function that Ulustrares the extreme complexity of the human brain. The human brain Is
truly a miracle that we rake for granted In dally functioning.
and, with a court reporter, the level of complexity is obviously
extreme. The functions necessary for such a task are muiUfacRoben Tompkins reaived a doctorate in COIJIISeling psychology from the
Univerlity of South Dakota in 1973. He holds cliplomate status from the
American Board of Professional Neu-opsychology and is a fellow of the
American Academy of Professional Neuropsyctrotogy. as welt as an examiner for the ABPN. Though his work as a lic:ensed psyr:hologist has been
primarily In neuosciences at a large medical center In Billings. Monl.
he is current~ In private practice. specializing in net.ropsychology and
psychotherapy with a special interest in posl·llaumatic stress disordet.
This lllticle was commissioned by the United States Coun Reporlf!fs
Association as a S8fVic:e to its constituents and to the court reporting
profession as a whole and is reprinted here with their permission USCRA
is on the Web at YMW.usaa.org.

()vervit'\\' ()r

"I(• nl ~fill

The brain Is currently understood as Involving systems
rather than only specific areas. The major systems and their
general role In cognitive functions are srUJ being investigated;
however. the general networks are now accepted as the basis of

JOURNAL FORTH£ RUORTINC AND CAJ'TIONING PROFESSIONS

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lo«RCH1009

. .rHyperactivity Disorder, for example, we see this process disturbed. Usually because of subde br2ln dysfuncUon, the law of
strength Is dlsorganl2ed. Selectlve attention Is usually disturbed
with either hypo- or hyperactive activity. Persons with this disorder tend to habitually attend to Irrelevant lnfonnatlon. This system Involves
the ascending and descending tracts In
the brain. The ascending tracts carry Information to the higher centers and the
descending tracts cany Impulses to the
lower centers of the brain whlch Involves
a number of functions. but one very Important function Is a regulatory lnOuence
of the cortex or higher brain on the lower
centers as weD as recruiting energy from
the lower brain.

the functioning brain. Ongoing research Into the finer points
deepens our understanding and provides new Insights Into the
most complicated organ on the planet
We know these areas of function from early cllnlclans and
researchers but also from new technology
such as PET and SPECT scans, as well as
from neuropsychological assessment and
research.
Cognitive skills Involve "domains· that
Include overall globaiJunctlons such as lnteUlgence. Intelligence Is broken down Into
two major cognitive domains of verbal and
nonverbal. More than educational skills,
intelligence Is thought of as Ould thinking
ability.
In addition, speclftc functions Include
memory. executive, speech and language,
motor and psychomotor (fine motor dexterity. for example), attention, conceptual/
reasoning. and sensory skills.
1bday we realize that there are specific
areas of the brain that are responsible for
specJfic skills such as speech. The current
rhlnklng Involves not only understanding
lhe functions of specific areas of the brain
but the major networks.
When performing a highly complex
skill such as court reporting. we are referencing the executive
functions. Tile executive skUls involve the anterior or frontal
networks. These skills Include planning. organization, selfstructure, regulation of behavior, and verification for both verbal and nonverbal behavior. The executive skills are dependent
on Intact structures of olher functional systems or units In order to function. As we will see, these systems are built upon
each olher In a vertical manner.

Functional Unit 2
The second functional unit Involves
reception, analysis, and storage of Information, both verbal and nonverbal.
The primaJy or projectlon zones fadUtate receptlon and analysis at the basic or
elementary level. This zone Includes the
occipital cortex (the surface and posterior
gray matter), the temporal conex necessary for dJScrimlnatlon ofsounds and recall of sounds (the area on the lateral side behind the frontal
brain), and the parietal conex, which Is necessary for sensory
functions espedally from motor sources (behind the temporal
lobe).
The occipital conex (surface) Is an area of the brain responsible for vtsual recognltlon and discrlmlnadon of differences In
subtle visual Input such as letters or nwnbers.
The temporal cortex allows differentiation of and analysis
of combinations of sounds, rhythmic recognJUon, spelling. and
comprehension of speech and nonverbal cues. Damage to these
zones usually results In spelling problems, poor retention of
acousUc Information, and decreased conceptual functions, Including the abUlty to understand language and nonverbal cues.
From birth, most persons have neurons or nerve cells In this
region that are speclftcally sensitive to sound.
The secondary frontal region, or the premotor cortex, ls
responsible for complex, purposeful. and sklUed movement.
Motor skJJJs are smoothed with norma] brain function In this
area with the assistance of the cerebellwn. Speech Is dependent
on the left frontal region. Certain types of expressive aphasias
occur with problems In this area of the brain. Damage to thls
area often leads to a defidt In speaking Ouently. This Is thought
to be due to an lnablllty to switch from one sound to another
flexibly.
Secondary zones are associative ln nature. They receive Information from the primary zones and facUltate analysts. storage. and synthests of sensation from various parts of the body.
The tertiary zones are the overlapping regions that allow the
various regions to communicate rapidly and effectively. They

Functional Units of the Brain
A.R. Luria, a professor of psychology at the University of
Moscow, hypothesized lhree basic functlonal units Involving
both verbal and nonverbal skills.' His work was based on extensive research Into the specific and general systems Identified.
The brain Is also divided Into right and left hemispheres connected by the corpus callosum, the connecting structures that
allow the two hemispheres to communicate. Women appear to
have a richer and more developed corpus callosum. Within the
second and third functional units, lhere are primary. secondary.
and tertiary zones that will be briefly elaborated.

Functional Unir I
This unit has the sole responsibility for consciousness and
alertness, cortical tone, waking. and selectJve attention. which
Involves the law of strength. This Is a part of the brain that Is
basic for survival.
TI1e law ofstrength Is a coqcept first proposed by Pavlov. The
principle essentially states tha't strong stimuli evoke a strong response and weak stimuli, a weak response. In AttenUon Deficit

JOURNAL FOR TilE REPORTING oi.ND CAI'TIONINC PROFE.SSJONS I MARCH Z009

35

3$

are zones that overlap various sensory
modalities and lead to complex mental
activity. Simultaneow synthesis or symbolic and elementary Information Involving memory and organJzed patterns
are Involved at this level.

Functional Unit 3
The third functional unit Involves the
anterior or frontal regions of the brain
responsible for planning. organization,
and verification of both verbal and nonverbal Information received from the
other functional units. Th1s is the most
recent evolutionary part of the brain ln
humans, allowing for more complex behavior.
The primary zones Involve the motor
strip or centers at the cortical or surface
leveL Titls region assists with complex
synthesis of impulses Into movement
and organization of motor output
The secondary front31 zone Involves
the premotor cortex that is necessary for
complex lntenUonal movement Writing
difficulties are noted with damage to this
area.
The tertiary region or the frontal
region is necessary for motor and premotor output Voluntary motor behavIor, Involving motor functions of the
extremities or with motor speech, Is
dependent on this area of the brain. Intention, regulation, and verification of
directed behavior Involving planning are
dependent on this area. There are strong
assodations with the speech centers with
this tenlary region. Importantly. highlevel attention is seen due to Inhibition
of excitation of irrelevant Information.
Complex organization is subserved by
this area of the brain as well. Complex
sequencing of Information Is processed
In this region as well.
The frontal region of the brain Is necessaryforthethlrdfunctlonal unit to exist.
It Is critical for any complex mulUfaceted
functioning at a high level and certainly Is
Involved with court reporting. The ablllry to sequence or automatically synthesize sound and motor skills Is dependent
on this zone. New learning Is difficult If
there are weaknesses In lhls aru, because
the Individual Is not able to verify and automatically make alterations.

Court Reporting
Processes

tor output is necessary for Information
already heard, comprehended. and pro-

As is apparent. the brain is extremely
complex and works together In larger
systems or networks. while certain areas
of the brain are responsible for specific
skllls. For very high-level Information
processing such as court reporting. the
Individual must have extremely high
functions In all of the aforementioned
regions.

In summary. the sounds have to
be processed by the temporal lobe, re-

First, the Individual must have the
Functional Unit 1 operating well In order to differentiate Irrelevant from relevant Information and be able to differentiate sounds.
Second, sound is detected by the temporal lobe on the left and reoilled long
enough to be stored and quickly transferred to the association areas for comprehension and meaning of the combinations of sound. This Information Is
then sent lo the visual centers of the brain
for Integrating sounds and symbols,long
ago blended Into units of sounds and
visual symbols to make words. In the
learning stages In childhood, there Is a
visual component involved as well. For
example. a child recogn1zes a chair visually. later learns the sounds for the word
·chair; then automatically can speak
about a chair without conscious awareness of the visual component, using
speech to communicate. We use gestures
to augment this visual component
Once the lnfonnatlon Is decoded or
understood, It Is then sent to the frontal
networks for motor output In the case
of a court reporter, a very rapid fine mo-

cessed.
tained long enough to be encoded or
stored, then sent to the assoclation areas
for understandJng. then sent to the ocdpltallobe for the already learned sound
blending Into words, and then sent to
the cerebellum. which helps to Integrate
and smooth the process. The Information is then sent to the motor area for
output and is simultaneously verified by
the frontal network for acxu~ Changes are made lnstantaneowty. all the while
sequencing with new lnfonnation to be
Input and processed. This process Involves complex attention refemd 1o as
dlvlded attention and working memory.
Divided attention Involves perfonnlng
one task whOe holding another competing piece of Information In memory.
In th~ ca5e of a court reporter, dealing
With already spoken Information and
simultaneously processing the immediate Incoming Information Is synthesized
automatically.
With realtime reporting. the complexity is Increased. The reporter must
possess the lmmedlate ability to process
not only at the level descrJbed but with
an extremely high level of sophlstlcatlon, have superior language skJlls ln a
number of subject areas, and automatic
sequentlal skills. Interspersed In this
complex network is the ab!Uty In language to make subtle differentiations of
the complex English language.
Court reporting Involves extremely
well-developed cognitive flexibility. sequencing. and muiUfaceted processing
of language. sensory Integration, and
motor skills at a high level of sophlstJcation. WhDe technology makes the deUvery of Information possiple, the most
Important feature In the process is the
highly functional system represented by
all three functioning units Interdependent In the amazing human brain. •
'Luria. A.R. (1973). The l%rkln8
Brain: An Introduction to NturoJlS)'Chology.

JOURNAL FOR THE REPORTING ANO CAP110NINC PROFESSIONS I UAJlCH ltx8

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OB/03/2010 12:37

· From:

to wonder ff they are with "the larger com•

f
of'•

ave

..~
to

and ~

:I

mW)ity or nor."

And, be added, If the rabbi tells a joke
and c:Verybody laughs, the CAllT reporter
can write "laughter fn the room." 10 someone who can't hear that or is not aware it
Is bappeninl can at least read and know
~hat'• aoing on. "'t ~ not slve the deaf
person the equivalent of the hearing per~

auvf

sciii'• ~ofsynagogue, but it gives
die dial penon a whole lot ofaa:es.s,• saJd
J.elgb:
.'the service fa provided this year by the

hat

~ ctaptlonem, a Montdair business
~ by tQWn n:sldent Rand! Pdedmm,

are~~

tof. j

~ n~ ce.rtifiecf. CAXI' provfde:s: She

bat

b~the IClVicca at a a:duced rate,
~ ~naiiWbctalsotecelvcd a amnt from

r:.•

nn-

Mifi9:Wut ABLE, a consortluin of lay
}~en and profe.ulonall repr~g the
qi~·IU!edl c:oramwdty.
·. ~ l'eaJi the effort was sponsored by
tb~: jev..tsh Deaf and Hearing Impaired
oiuocl1, which may still ofi"er support
~~ tbfa year.

lU
be~

lm- •
al.

chslalet-

de,

od,

'

ibhJnna Gisbef!l IsamffWriterwith the New
J.e-r$ey Jewish News. This artide Is reprinted

With pennks/on.

IDg

-.,

BEYOND

a.

a11

C

·o

THE

M. F 0 R T

Z 0 N E

I l · Accuracy of
J
t
f
"
!
I
r

Sign
Interpreting
and Realtime to
Deaf Students

~

BY MONETIE BENOIT

~

ast month I shared "A Number of
Firm In Science Education with
Ksiren Salde~; Ph.D.• Karen created
'firsts,' giaduating with a bachelor's
In newosc:lence ami acceptance to
the Cent~ for Neuroscience it the Unl~
vetSity of Plttaburgh for gmduate work..·
Karen was born severely hard of hearIng. She lost a~t aU hearing by 1991
and had a cochlear implant that faUed.
Then Karen "bad to Jearn American Sign
language to be able to get infoJDU~tfon
In school. • Karen Sadler used ASL whi1e

i

<}

t
t

~-

1

f
I
~

l

Jf74B P.002/014

wotldng on her bachelor's and muter'.s
Wlth the continuing closure of schoob
degree. When &be started her: Ph.D. worlc,
{or the Peal in the Un1ted States and the
ICaren begantoworlcwlth CAR.Tprovldem.
placem.ent o( these Deaf atudenm into
Now we share detalb within Karen'a May
publfc achoolt, it has become necessary to
2009 adem:e education doctoral. work.·
find means to ensure these 1tudents obtain
"Accuracy of Sign lntczpreting and Realthe wne amount and the aame quality of
11me Captlonfilg of~ \lldeos for the
lnfonnatlon available to their bearing
Delivery oflrutructfon to DcafStudenta."
peera.
.
~ a preface to Karen Sadler'• doctor
·Steno-baaed SCtVlces are becoming
of pbiloeophy work. I want to sham that
more common in secondary schaols, but
the renn "Deaf' (bfg D) Ia a reference · reseueb is needed to determine h"" accu~
for lodivlduala who typk:ally uae sign lanrate the JniOnnation is that these students
pge 111 their fiut language. My opinion
are receiving, especlally Iince Deaf stu•
is this detail will assist court repottezs IUUi
denta c:onl:fnue to have problcm.s meetfng
students to have a greater undeutanding
natlonalabmdards In science aad math.
within Iearen's research. rn let her tell you
Since Deaf studenta must rely upon
about herr~
aupport serW:ea. IUCh 81 lnt:etpteteis and
RESEARCH ON ASL AND RI!ALnMI!
EFFICACY
·When I started, I woxked on the fntetpretera 6rst. Interpreters were easy 1:0
find. I had a bomb1c dmt: for two yean
wtth different people I hkcd to 'traDslate'

with m.e. One pers~ did haidly
anything with the tape for a ycm; 1DKl
a professional interpreter I know alao
didn't do much of anytbfng w.lth it for a
year. [ ended up tranalatlng the maJority
of the int:elptcter capes with asslltaDce
tapes

to ensure It

W8l

being done correctly.

CAR.T peuolUlel were eadel; except trying m find ~I locatl!d some via WOld
of mouth but had to taDc to a couple of
groups that do court reporting here. They

were an very professionaL
In a JJ!ent world, Deaf studenrs mwt
rely upon odJ¥1 to get their fnfOrma.•..
t{on in the classroopt, espeda)Jy fn pub~
school classrooms, where teachers will be
unfamiUar with Amerlcan Sien language
and cannot &pend a1gnlficant time teaching one student with special needs.
It has become nec:CAaif to use third~
party communl.catma to convey classroom
information. Until recently; sign lanauaie
interpreter~ were the wual choice for Deaf
students.

Wlth the advent o( the computer ~d
reporting, more and more Deaf stu·
dents In college. as well 81 Deaf professionala, are choosing to use court repoJ1en
in the classroom.
The drive is on to udlhe court reporters in achoo1s from K through 12. But just
court

because third-party communlcaton are
available In a classroom does not guaran·
tee accuracy of delivery, especialJy in c:Ws.

steno-based systeml, it was obvious that
the first step was to find out exactly how
much sdence infOrmation flactuaJly conveyed to the Dealatudentl.
In my study. sevum! NASA videotapes
were used. Each lnb:Ipretet and captioner
weJC tested separately.

.

.

My dla:sertatfan absttact stated:
'Iba purpose o( tLk st~~cfy wu to qaauzita·
lively cxuniDe the fmp&ct ol ~ l11ppOit
aenf.cc pmvfdaa on the qualitr of idaaca lnfar.
matlon ....um1e to Deaf' atudeu~~ In quJar lderu:e ciauroams. ThP:c cllftilzeor ~ t1w
were developed br NASA filr Lfeh sdlDOIICI-=e
cJummns were ~ for the &llldy, ~

!or dtffseat c:onc:epiJ lind voc:allufu., to Lc aamlned. 'Ibe focaq wu cin the III:CIIIIey ri!DIIIIadou
u IDeUIIRd by die numhu of by ICimce words
Included In the mWalptl (c:apdom) cr Yldeos
(In~.

InWPretels wer~ videotaped, 10 that
what 'they signed could be documented
and transiated.
. ;. CART penonnel delivered their ttan·
sCript to me. They we:c not allowed to
COII'ect their mistakes because I wanted to
see qacdy wbai: Deaf studentl would see
In the clasqporn.
Many Deafrtudenta lag in reading •ldlls
and would not read the voluminous notes
given to them. So what thev obtained In
the classroom, on the screen from a srenobased system, would be the ihformadon
they would retain.
Three people Involved fn sclence
&eored the twucrlptl. 1he number of key.
science wotds coneetly delivered by each
individual and each group wu counted.
There was a slgnlfu:ant difference be·
tvieen what" the lnterpretera were able to
deliver versw what the captioners deJiv.
ered.

rooms Involving sclcnce and math.
~....

1 JOURNAL

FOR 'nfli R.EroRTINO AND CAPTlONINO PROFESSIONS

1 APiliL zoto

25

OB/03/2010 12:37

From:

CART pmvidets bad an accuracy ~
of 98 percent c:omparcd to the lntapretea' acanacy rate of73 pm:ent and were
lDund to be sfgnfficandy more ac:cwate In
the delivery of science words as compared

•i

l.
I

to slgt\language intapreten Jn thb atudy.

The few mistakes made by CAKr pro~·
vldera were probably due to the fact that
most ~en the software program wed a
legal dlctioruuy, and certain science terms
were not recognized by those dictionaries.
Background infortnatfon provided by
all the pardclpanm indfca.:ed that the ·
amount of tnlnfng recdvcd by court re•
porten, u well as the met that the ttalnJng
b atandanilz.ed across the nation, made a
huge diH'erencc in the .Information that ·
would be conveyed to Deafawdents.
Interpreter~ Cor the Deaf do not re~
celvc the laDle qua]Jty of training, nor are
they required to meet the same natfaaal
acandatds. It varies &om state to atab: and
from ~don program to proaram.

'
!i
11

:\

1:

,.
I

So, according to thb fnfoanatfon £rom
thb atudy, does that mean ccboola ahould
rush out and bfre couct reporters instead
of afgn language intcrptetera £or Deaf atu~
dcntsl Not necessarily.

Deaf students come at~ Eng}Jsh lan~
guage later fn life Ibm bearing atudena.
Their vocabulary fs o&eu smaiia; and the

readme alcills requfn:d to follow a a~:en~
based systcJD fn the c:lassroom may malce
these &y~tems di8icuit for fODle atudents to
follow. It has yet to be determined If and
how much realtime captioning Improves
leaming in Deaf students.
One thing that wiD determine how
muc:h these systems can be used in sec-ondary dassraoms b the speed with which
the student will see the captlonfng on the

acreen. Previous reaean:h IW shown that
the £utu the mtc of c:apdonlof, the less
undcrmndlng thme. b of the mat:edal.
IDformadon that Ia moved too qutddy off
the ICteCD. not ooly deaeuea compreben.
alan, but iiuatmtes Deaf atudents. If atu~
dents can be given some type of control
over this rate. it may allow !or more com~
plete understandfn&',
Equal ac=u and cpponunlty fn cduca~
tfon for Deaf studenta will DOt be acblcv~
able until they ue able to receive the aame
Information u their bearlng pem. Since
they depend upon lnfoanatlon given to

1748 P.003/014

them through thhd-party co~~~muukaton,
It b vital that that 1nf'otmation is amect.
'Thi! ~ research demonstratc:s that :~u:no~hascd systems could
lnaeast: the amount of inttnmatlon that
Dellf 1tudents rcc:elve in pubJic class~
rooms, and that would probably lead to
better achJcvemcnt In science and math ··
on standardhcd te.stJ.
JCR ConUfbutlng Editor, MoneUe Benoit.
B.BA. CRI, CPE. may be reached at www.

CRRboolcs.com and v.ww.AHTCS.com. J(;Jren
Salder, Ph.D.. may b11 reached at Jdseduethk:[e-mail]. Her dimttatlon can be
aamsed 11t http;.l/etd.llblill)'.pftt.edU/ETDI
avallableletd-07212009-20 11441.

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.26 AP~IL

JOIO

I

JOURNAL FOil 11m P.EI"OitrtNO AND CAl'TIONINO PllOFESSIONS

Recerved T1me Jun. 3. 2010 !2:57PM No. 0158

I

www.NCIV.callo>e-cq

ts:u~-CV-UU-'41-L.;:)\.1 -r-U.l

L:IUl,; tt '~'-"'

,-ucu. u11c..~ 1 1

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VITA
Peter J. Seiler
EDUCATION

College:

Attended Lewis College (Romeoville, Ill.)
Graduated: June, 1967
Degree: Bachelor of Arts
Major: English with minors in Social Studies and Education
Activities: Dean's List, Varsity Wrestling, Letterman Club, Dormitory
Hall Proctor, College newspaper reporter
Attended DePaul University (Chicago, Ill.)
Graduated: June, 1970
Degree: Master of Arts
Major: DeafEducation
Attended Illinois State University (Normal, Ill.)
Graduated: October, 1980
Degree: Doctor of Education
Emphasis: Edueational Administration with additional studies in Special
Education Administration
Dissertation: Experiential Factors Affecting Integration of Special Needs
Students

EXPERIENCE
July, 2009
To
Current
Duties

,u.r·"
_
..

Nebraska Commission for the Deaf and Hard of Hearing
LincoLn, Nebraska
Executive Director
Recommends strategic goals and policies to the Board; develops and
monitors the budget; carries out the policies and regulations ofNCDHH as
formulated by the Board and the Legislature; develops programs and
marketing plans to ensure client services are delivered in an effective and
efficient manner. Oversees the five strands of services of the
Commission: Advocacy, Equipment and Technology for Deaf and Hard of
Hearing people, Mental Health Services, Hearing Aids Assistance, and

·.

ts:U~·CV·UU;j41·L~v

May,2001

ff ~~~-~

ruttu.

VI/~~

11

rctytt o u• 1u- rctytt 1urt ,u..,..

Kansas School for the Deaf
Olathe, Kansas
Director of Student Life

To
June,2009
Duties:

Responsible for Residential Services Program and Athletic Programs.
Responsible for developing school-wide technology plan. Responsible for
staffing pattern and hiring, training, and evaluation procedures. Planning,
directing, and evaluating staff, curriculum, and programs. Planning,
implementing and monitoring division budget. Applying school, state, and
federal policies, rules and regulations to current situations.

April, 1995
to
September, 2000
Duties:

Duties:

Arkansas School for the Deaf
Little Rock. Arkansas
Superintendent

Responsible for K-12 educational programs, State-wide outreach
programs, Deaf/Blind program, residential and after-school programs.
vocational/technological educational programs, and special needs/multidisabled student educational and functional training programs..
Responsible for staffing pattern and hiring, training, and evaluation
procedures. Planning, directing, and evaluating staff, curriculum, and
programs. Planning, implementing and monitoring budget including
interacted with the state legislators to secure sufficient funding for the
school. Budget includes state appropriations and federal grants. In
addition, worked with local restaurants in conjunction with the ASD's
annual fund-raiser activit}!. Applied school, state, and federal. policies,
ndes and regulations to cmrent situations. Served as the school's
spokesperson when interacting with the media, the legislators and the
community

September, 1989
to
March, 1995

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Interpreter Certification, Licensure, and Development. Acts as
spokesperson for the Commission with the community and the
Legislature.

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Illinois School for the Deaf
Jacksonville, Illinois
Superintendent

Responsible for K-12 educational programs, State-wide outreach
programs, Deaf/Blind program, residential and after-school pl'Ograms.
vocationaVtechnological educational programs, and special needs/multidisabled student educational and functional training programs.
Responsible for slaffing pattern and hiring, training, and evaluation
procedures. Planning, directing, and evaluating staff, cuniculum, and
programs. Planning, implementing and monitoring budget which includes
both state appropriations and federal grants. Applying school, state, and
federal policies, rules and regulations to current situations

8:09-CV-00341-Lt;(.; -t-l;:i;:s UOC If 1~l!-4

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November, 1984
to
September, 1989
Duties:

August, 1975
to
May,1978
Duties:

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Nebraska School for the Deaf
Omaha, Nebraska
Administrator II (Campus Administrator)

Responsible for K-12 educational programs, athletic and physical
education programs, vocationaVtechnological educational programs, and
special needs/multi.:disabled student educational and functional training
programs. Responsible for staffing pattern and hiring, training, and
evaluation procedures. Planning, directing, and evaluating staff,
curriculum, and programs. Coordinate and implement IEP, assessment
procedures, and due process procedures for enrolled students. Served as
case manager for alllBPS at the school. Assist in the planning,
implementing and monitoring of departmental budget. Applying ~chool,
state, and federal policies, rules and regulations to current situations.
Coordinate Summer Parent Workshop and supervised outreach programs.
Served as tbe curriculum director. Served as acting administrator for the
Nebraska School for the Visually Handicapped, 1988.

May,1978
To
November, 1984
Duties:

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National Technical Institute for the Deaf
At the Rochester Institute of Technology
Rochester, NY
Chairperson of various departments

Served as department chairperson for support services for the College of
Liberal Arts. Established and served as the chairperson for Physical
Education and Athletic Support Department. Served as the coordinator of
staff training for the National Technical Institute of Technology.
Responsible for selecting and evaluating staff. Responsible for
department budget development and monitoring. Along with regular
duties, taught college level courses and served on numerous planning,
curriculum, search, and reSearch committees.
Received tenure: 1984
Promoted to Associate Professor: 1984
lllinois State University
Normal, nlinois
Instructor, Department of Special Education
Served as an instructor in preparing students to become teachers of the
Deaf and the l:Jard of Hearing. Taught professional core courses in Deaf
Education. Served as supervisor for practicum and student teaching
experiences in public and residential school programs.

8:09-cv-00341-LSC -FG3 Doc# 192-4

September, 1972
to
June, 1975
Duties:

Duties:

Hinsdale High, Soutb, District #86
Darien, Illinois
Teacher

Indiana School for the Deaf
Indianapolis, Indiana ·
Teacher

Taught high school deaf and hard of hearing students in English, Reading,
and special topics/ Served as Jr. High football and wrestling coach.
Served as Senior Class advisor and Student Council sponsor.

September, 1967
to

June,1968

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Taught high school deaf and hard of hearing students primarily English
and reading. Al$0 taught career orientation courses. Served as resource
teacher for the deaf and hard of hearing students who were placed in
regular classrooms. Served as vocational counselor. Served as Jr.
IAD/NAD advisor.

September, 1969
to
August, 1972
Duties:

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St. Patrick High School
Chicago, Illinois
Teacher

Taught high school English and Literature

ADDITIONALE~LOYMENT

Able Hands, Kansas City, MO, Instructor for Sign Language Interpreters; gave two
presentations to interpreters in KC area for their CBU
1) Vocabulary Development with signs focusing on political vocabulary
and governmental signs
2) Classifiers
Maplewood Community College, North Kansas City, MO,_Sign Interpreting Program,
Instructor, American Sign Language (2008)
MacMurray College, Jacksonville, Ill., Adjunct Instructor, American Sign Language
University of Nebraska at Omaha, Omaha, Neb., Adjunct Associate Professor in the
Department of Counseling, Special Education, and Speech Pathology.
Courses taught included: Teaching Content Subjects to Heal'ing hnpaired,
Bi-lingual/Bi-modal Language Development and Curriculum, Sign
Language. Developed course outline for Sociological Impact of
Dellji1ess.

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Indiana School for the Deaf, community sign language classes for parents and
community members.
Hinsdale High , South, community sign language classes for parents and community
members.
Lombard Adult Education, community sign language classes for parents and community
members.
Chicago City College, Adult Education Division, English for Deaf Adults

PROFESSIONAL CERTIFICATES AND LICENSURES
Nebraska Intelpl'eter License: Licensed as Deaf Intermediary Interpreter
Kansas Teaching Certificate:
Deaf Education, Building Administrator, English (7-12), District
Administrator
Arkansas Teaching Certificate:
Deaf Education, Superintendent, Secondary Principal
lllinois Teaching Certificate:
Secondary English, Deaf and Hard of Hearing, Principal, Administrative,
Superintendent, Approval for Special Education Director
Nebraska Teaching Certificate:
Secondary English, Hearing Impaired, Principal, Special Education
Supervisor, Superintendent
Council on Education of the Deaf
Professional Certificate for Administration
Convention of American Instructors of the deaf
Class A- Permanent

CONSULTATIONS
Great Bend School District (KS) -served as a consultant to advise on behavior
management for a Deaf child. (2008)
Law Firm of Davenport, Evans, Hwwitz, and Smith, LLP (Sioux Falls, SO), specifically

Melissa Hinton, re: the maUet· of Tracey L. Etcbey, et al, vs. Dr. Jon C.
o~,etal(2008)

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Kansas State Department of Education; member of Committee to develop indicators for
American Sign Language as a part of the World Languages (foreign
languages allowed to be taught in school for credit) (2008)

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Kansas State Depa11ment of Education; member of committee to develop deaf education
guidelines_ for K-12 and special education programs in Kansas (2008)
State of Louisiana: Task Force to Review Policies and Standards for the Louisiana
School for the Deaf, Louisiana Department of Education (1999-2000)
State of Arkansas: Steering and Development Committee: develop and implement
policies and procedures for distribution of1DD and other telephone
assistive devices; and also develop eligibility determination for the
distdbution. (2000)
Law Office of Kenneth C. Chessick (Schaumburg, Ill.) re: the matter of Mendoza vs.
Pepa, et. al. and Deberry vs. Shennan Hospital, 1990; re: the matter of
Bovini vs. Delnot· Community Hospital, et. al., 1992, 1996-1999)
Jacksonville (Ill.) School District #117, Referendum Steering Committee (1994)
Law Firm of Joel M. Goldstein and Associat~ (Chicago, Dl.}, specifically Sandra Weber,
re: the matter of Dosch vs. Children's Memorial Hospital, et al. (1994)
Illinois State Board of Education: Teacher Certification Review Committee (deaf
education certification requirements) (1992.. 1995)
(""

Illinois Interagency Task Force fo1· Hearing Impaired/Behavior Disordered Children
(1991-1995)
Nebraska Department of Education: Interagency Task Force- served as a consultant in
defining and recommending ways that agencies can interact and exchange
services, resources, and programs (1988-1989)
Nebraska Department of Education: Consolidation Committee- served as consultant in
investigating d1e possible merger of the Nebraska School for the Deaf and
the Nebraska School for the Visually Handicapped; and the Nebraska
School for the Deaf and the Iowa School for the Deaf: chaired the Fiscal
Analysis sub-committee and the Cuniculum sub-committee (1985-87)
Nebraska Department of Education, Verification Guidelines Committee- served as
consultant in developing verification guidelines of handicapping
conditions and in particular hearing impainnent for inclusion into the State
Rules and Regulations. 1986
Nebraska Department of Education, Special Education Advisory Council, served as
technical advisor to the Council on matters related to special education
service models and to residential programming, 1985-88.

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University of Nebraska at Omaha- provided consultation to the Department of
Counseling and Special Education in its efforts to acquire CBD
endorsement, 1985-86.
Rochester Catholic Diocese (NY), Commission on Religion Education of Deaf Children
- fJSSisted in developing and evaluating curriculum and textbook
evaluation and selection, 1982-83.
Genesco School District (NY), - consulted the faculty on integlllting deaf students in their
classrooms, assisted teachers in ways of maximizing deat1hearing student
interaction and learning, recommended instructional strategies for the
deafstudents, 1981.
Jamestown School District (NY)- provided consultation to Special Education Director
on appropriate testing, curriculum, instruction, and programming for deaf
students, 1980.
New York State School for the Deaf (Rome, NY), - consulted on teacher in-service
training, appropriate counseling program, small scale program evaluation,
and student perceptions, 1979.
Illinois Office of Education- served as chairperson of the task force on Appropriate
Educational Environment for the Hearing Impah-ed, 1977-78.

POLICY BOARDS
National Fratetnal Society of the Deaf; member of Board ofDirectors,
Secretarylfreasurer of the Board of Directors (2004 to 2010)
State of Arkansas, Telecommunication Assistance Program, Advisory and Policy
Committee, Arkansas Rehabilitation Services (1997 - 2000)
Eades Home for Multi-disabled Women and Men (Jacksonville, Ill.), board member and
Secretary (1989-1995)

Monroe County Association for the Hearing Impaired (Rochester, NY), board member
and president (1980 - 1984)
New York State Education Department, State Advisory Panel for the Education of
Children with Handicapping Conditions, member (1978-1980)

PROFESSIONAL AND SOCIAL ACTIVITIES

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Arkansas Association of the Deaf: Treasurer (1995-98)
Arkansas Association of Educational Administrators: Member

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City of Olathe: member, Diversity Council; member, Persons with Disabilities Advocacy
Board
Conference of Educational Administrators Serving the Deaf: current
Gallaudet University Regional Center -Johnson County Community College:
Advisory Board: Member (1988- 1997)
Illinois Association of the Deaf: Member and Officer (president, vice-president,
Secretary)
City of Olathe, me1nber of Diversity Committee (2002-2008)
Member of Persons with Disabilities Advocacy Board (2007-present)
National Association of the Deaf: Member (current)
National Fraternal Society of the Deaf: Division #S: President ( 1997 to 2001)
University of Nebraska at Omaha: Advisory Council to Department of Special Education
and Counseling: Member (1981-1983)

AWARDS AND HONORS
National Fraternal Society ofthe Deaf: NFSD Scholarship Award (1975)
Oallaudet University Alumni Association Scholarship Award- two year grant to pursue
doctoral work (1976-78)
Monroe County Association for the Hearing Impaired: Certificate of Appreciation (1983)
The Health Association of Rochester and Monroe County, Inc.: Award for Outstanding
Community Service i11 Meeting Human Needs (1983)
Nominated as candidate for the Rochester Institute of Technology Eisenhart Award for
Outstanding Teaching (1984) ·
Received tenure and promotion to Associate Professor from the Rochester Institute of
Technology (1984)
Nebraska Educators of the Hearing Impaired: Award of Appreciation for Service (1987)\
Boys Town National Institute: Certificate of Appreciation (1987, 1988)
Nebraska State Board ofEducation: Resolution in Honor of Service (1989)
Lewis University (IIJinois): Disiinguished Alumnus Award (1992)

Alvin Eades Homes and Center, Inc.: Recognition Award (1995)
'Illinois Senate: Certificate ofRecognition for services to the Deaf and Hard of Hearing
people oflllinois (1995)

f""

.......

Nebraska School for the Deaf: Order of the Tiger (1995)

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City of Little Rock (Arkansas): Certificate of Appreciation (1995)
Sertoma Club ofNorth Little Rock (Arkansas): Certificate of Appreciation (1996)
Arkansas Association of the Deaf: Golden Torch Award (1999); Melitorious Service
Award (2001)
·

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Peter J. Seiler
May29,2010
Knowledge and Experience:
My vita contains a comprehensive picture of my knowledge base, training, and
experience. However I do want to point out the Nebraska Commission for the Deaf and
Hard ofHearing provides sign language interpreter assessment for Nebraska certification
and also issues Nebraska licenses for sign language practice in Nebraska. As the
Executive Director for the Commission, I am in a unique position to regulate the practice
of sign language interpreting for the Deaf and Hard ofHearing people.

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I also am a licensed interprete1· in the state ofNebraska. Nationally, there is a Certified
Deaf Interpreter from the Registry oflntOlpletel's for the Deaf (s~ discussion on RID
elsewhere in this report). In Nebraska, Deafpeople who choose not to get a national
certification (CDI) but want to be an intetpreter can get a QAST Deaf Interpreter (QDI)
license. My license allows me to serve as the QDI inte1preter when a Deafperson
preiems a situation where it is best to use a native or near native user to help the Deaf
person communicate. In that situation, a heating interpreter may request the assistance of
a CDJ/QDI interpreter. This is especially true fot· court or medical situations. CDI or
QDI interpreters are also used to assist Deaf:.Blind people in their efforts to communicate
with the sighted and hearing world.
Of special note is the fhct that, prior to moving to Nebraska, I have served as a Deaf
interpreter in other states (Diinois, New Y:ork, Arkansas, and Kansas). Those states did
not offer a state certification pt'Ogram for Deaf interpreters.

Finally, I am a consumer of sign language interpreting which means I use this service to
perform the duties ofmy position. I need to integrate infonnation for any given
situations :from a variety ofpeople such as the Governor, state legislators, court
personnel, Board ofDirectors members, staff members, clients, and so forth. This
obviously means that I must receive information consistently, accurately, and
simultaneously. As the manager for the Nebraska Commission for the Deaf and Hard of
Hearing, I encounter situations where confidentiality is critical and required. Because of
my deafhess, I rely on the use of sign language interpreters to convey and transmit
information ftom the other person(s). I also use sign languag~ interpreter when meeting
with my personal physician or other mtdical doctors for care and ~ent of my health.
Thus, my insights developed and influenced by my position as the executive director and
as a consumer coupled with my experiences as an interpreter enable me to comment on
the use of sign language interpreting for effective and efficient communication between a
person who has a hearing loss and a person who can hear but cannot use sign language.
My experiences allow me to offer insights into the profession of si~ language
·~

1

interpreting and in particular the issues of confidentiality and of third party participation.
I can also explain .how a person becomes certified and licensed in Nebraska.

Registry of Interpreters for the Deaf (RID):
The Registry of Interpreters for the Deaf (RID) is a non-profit national organization in
which they operate a national certification program for sign language interpreters. The
most important function that the RID provide is to uphold standards, ethics, and
professionalism for the sign language interpreter nationwide. The RID developed a Code
ofProfessional Conduct (CPC). The Code is actually a set of tenets that apply to their
members and interpreters certified by the RID. The Nebraska Commission for the Deaf
has adopted the Code of Professional Conduct for tHeir interpreters who receive a state
certification and/or are issued a license in Nebraska. If an interpreter is found to have
violated one or more of these tenets, that interpreter may have his/her license or
certification revoked by either the RID or the Nebraska Commission for the Deaf and
Hard of Hearing.
The tenets are:
1. Interpreters adhere to standards of confidential communication.
2. Interpreters possess the professional skills and knowledge required for the specific
interpreting situation.
3. Interpreters conduct themselves in a manner appropriate to the specific
interpreting situation.
4. Interpreters demonstrate respect for consumers.
5. Interpreters demonstrate respect for colleagues, interns, and students of the
profession.
6. Interpreters maintain ethical business practices.
7. Interpreters engage in professional development.

The Nebraska Certification and License Procedures:
The Nebraska Legislature set up the interpreter certification and licensure in Nebraska
through Nebraska Revised Statute 20-150-159. The law established a board called the
Interpreter RJwiew Board. This board has the authority, under Title 96, Chapter 1,
010.01, to deny, refuse to renew, limit, revoke, suspend, or take other disciplinary actions
against a license when the applicant or licensee if found to have violated any provision of
sections 20-150-20-159, or sections 71-4728 to 71-4732 or any rules established by the
NCDHH governing unprofessional conduct.

··-

The applicant for certification and/or license submits an application. After receiving the
application, NCDHH schedules a written test which covers vmious ethical situations to
assure the agency that the applicant is able to protect the confidentiality and
professionalism of his/her position. After passing the wrlttett test, the applicant then
makes ammgem.ent to take the Quality Assurance Screening Test (QAST) which is the

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state's assessment tool of the person's ability to accurately transmit inf01mation from
signed message to English and :fi'Om spoken English to signed message.
The QAST is given to the candidate at a location selected by NCDHH but usually in the
Omaha office. The candidate is videotaped during the performance test. After the
candidate has completed the performance test, the video of that performance is sent to an
outside private reviewing agency. The reviewers determine the level ofskill and reports
that back to NCDHH.
More infonuation can be found on the website:
http://www.ncdhh.ne.gov/intemreterdeyel.html

Third Party Concerns:
Creighton University School of Medicine has presented a set of technical standards that
supposedly assures tliat the medical students are developing skills and knowledge to
eventually practice medicine in Nebraska or any other state in the United States.
Creigltton University School of Medicine has stated thit the standard #B. Communication
is the source of disagreement with Michael Argenyi. It appears to be their contention that
the use of an interpreter will mediate Michael's judgments when dealing with patients.
Because of this statement (3nl paragraph, page 7), Creighton is refusing to provide
interpreting services to Michael.
Based on my experiences and knowledge, I disagree with Creighton Univet·sity•s
position. The use of the interpreter will not mediate or mitigate any infonnation no1•
negatively influence the doctor's judgment. The interpreter is not allowed to offer
opinions or observations about the situation between the deaf person and the hearing
person. Nor can the interpreter even discuss his/her experience outside of the interpreting
situation. The interpreter has to follow the same strict code of confidentiality that a
medical doctor has to follow. In short, the interpreter's only role is to facilitate
communication between the deaf person and the hearing person. The deaf person then
needs to take that infonuation and make his or her judgment on how to use the
information.

Role of Interpreter:

,.,...

.

The interpreter's main function is to facilitate communication between the deaf person
and the non-signer. While there are technological devices available, these devices do not
allow for intenJctive communication. People will find that using a sign language
interpreter will provide better intemction and more simultaneous interaction. The
interpreter also can identifY who the speaker is or where the noise is located. This will
help the deaf person participate better in large and small group discussions. Thus using
an interpreter would facilitate communication rapidly and allow for better discussion and
exchange of ideas, thoughts and opinions.

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Communication Access RealTime Translation (CART)
Communication Access Realtime Translation (CART) shows everytbing that is said as a
"caption" on a screen for Deaf and Hard of Hearing people to read. It is especially useful
for classrooms, plenary sessions or keynote sessions at a conference, or churches.
The CART pl'ovider has the same training as the court stenographer. The CART provider
uses the same devices but hooks it through the computer to an LCD projector. The
computer enables the CART provider to store words that may be used in the presentation
to better retrieve it d\U'ing the presentation.
The CART provider types almost sbnultaneously what is said into the stenotype machine
using a form of sllorthand. The computer translates that shorthand into realtime captions.
The process can be very quick and have a short lag time. "Lag time" means the time it
takes the CART provider to hear and understand what is being said and transmits that
into the stenotype machine.
The CART option has the advantage in that the Deaf or hard of hearing person can read

what is being said and can pick up vocabulmy from the CART captions. I think it is
especially advantageous to a person attending a class where there is a lot of technical
material.

Cued Speech:
The National Cued Speech Association has stated that cued speech was developed to aid
the acquisition of literacy skills in deaf students. Cued speec4 is not a language but
instead shows visually the phonemes (consonants and vowels) of spoken language. In
other words, it is more of a communication tool. It does rely on the person receiving and
the person communicating to Jmow how to combine the phonemes to make a word. Cued
speech proponents feel that deaf and hard of hearing people can learn to break down a
word similar to the way hearing clilldren learn English.

American Sign Language:
American Sign Language is a visual language that is now recognized in many states as a
world language. That means it can be taught in the schools as course elective or
requirement for graduation. To adequately explain American Sign Language (ASL)
would require pages and take considerable time. Suffice it to say that ASL conveys the
same concepts as other spoken language such as English and Spanish. ASL is not a
primitive language. It is not English anymore than Spanish is English. A sign may
represent a one-word concept such as "house" or it may represent a phmse such as
"what's up?". Research studies have shown that deaf children who start with ASL tend
to do far better academically. ASL has its own semantics, syntax, and grammar. As
with any other language, ASL grows and changes. Being a natural language, ASL has
·-..··

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many of the same components 88 the English language: phonology, morphology,
semantics, and syntax. It is a visual language in that the infonnation is expressed not
with sounds but with hand shapes, physical location in relation to the body and facial
expressions. It is deemed an advanced language in that it can express abstract thoughts.
M~nually Coded English:

Michael Argenyi indicated that he is not fluent in American Sign Language. Therefore he
requested a different kind of interpreter. He specially asked for a Cued Speech
interpreter. Those individuals are hard to find 88 Cued Speech is not often considered for
interpreting. Instead, I suspect that Michael would benefit .from using an interpreter who
can use a form ofManually Coded English. The most common fonns are Signed English
and Conceptually Accurate Signed English {CASE). Most interpreters can do CASE.
Signed English systems tty to match the word used with a variety of signs. Advocates
feel that deaf and hard of hearing children can learn English the same way 88 hearing
children. The arguments are similar to those presented by Cued Speech supporters.
Using Signed English requires the person to add to the root signs the endings such as the
word "really,. The word "really', in Signed English would be signed using the root sign
for "real, and then spelling LY immediately after that.
Conceptually Accurate Signed English means that the person is using ASL vocabulary in
English syntax. Basically, the interpreter is making sure the concept used in English is
expressed still in ASL by selecting the sign that approximates that concept but making
sure that the English sentence structure is used.
Michael would benefit from using CASE because he can use CASE as a support cue
system when he lipreads the speaker. He also can rely on the interpreter for.those
speakers who are seated behind him which prohibits him from lipreading them. This is
especially true in a small4iscussion group where the discussion tend to be rapid fire and
not contingent on a moderator to identify turn taking.

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Peter J. Seiler
Legal Consulting Fee Schedule
l. Reading materials and preparing written opinions

$150.00 an hour

2. Phone and in person meetings

$175.00 an hour

3. Depositions and Court Appearances

$200.00 an hour

4. Mileage:

.SO per mile

s.

Motels are arranged and paid by the hiring agent.

6. Meals will be receipted.
7. Expenses incurred will be receipted where possible

. 8. Sign language interpreters will be receipted or arranged by the hiring agent
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CURRICULUM VITAE
N~me:

Britt Ashley Thedinger, M.D.

Business Address:

EAR Specialists of Omaha
9202 West Dodge Road, Suite 200
Omaha, Nebraska 68114
(402) 933~3277
415 E 23rd St.
FremontJ NE 68025
9968 Spting Street
Omaha, Nebraska 68124

Home Address:

[phone]

Date ofBitth:
Place of Birth:
Citizonshlp:
Sex:
Marital Status:
Spouse's Name:

July4t 1957
Kansas City. Missouri
U.S.A.

Mate
Married

Children:

Kelly
Britt Ashley Jr., Ainsley Elizabeth, and William Barrett

Social Security Number:

510-58..4508
Bishop LeBlond High School
St. Joseph, Missoul'i
Vanderbilt University
Nashville, Tennessee

1979B.A.
1984 M.D.

University of Kansas Medical School

J.!gstdo&,t~l Iodrung:

19 4-1985

Kansas City, KS

Intern in General Surgery - Saint Luke's
Ho$pital • Kansas City, Missouri
Resident in Otolaryngology-Head & Neck Surgery
Massachusetts Eye and Eat Infirmary .. Harvard University,
Boston, Massachusetts
7

Fellow in Otology/Neurotology - The Otology
Otoup, P.C., Nashville, Tennessee

1989-1990

Nebraska
Iowa

lJ.G.ensure;
Board Certitjcatlon:

.

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18188
32299 (inactive)

Ame1ican Board of Otolaryngology, 1989
Diplomat, National Board of Medical Examiner~

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P.006

Honors agd Al!a!d~
Listed m "Best Doctors in America" Woodward/White, Aiken S.C.
Graduated cum laude from Vanderbilt University
Ciba Geigy Award) 1984
Alpha Omega Alpha, 1984
Delegate Young Physicians Section- American Medical Association 1996~1998
,-e}'~hing Background_;,

1993-

Volunteer Faculty- Clarkson Family Medicine

1985-1989

Clinical Fellow in Otolaryngology, responsible for
teaching Harvard medical students

Program

frQ.fefslonaJ __Qrga~;lizaU,on MembersJlips;
American Medical Association
American Academy of Otolaryngology-Head and Neck Surgery
Fellow American College of Surgeons
American Tinnitus Association
American Neurotology Society
Otosclerosis Study Group
Metropolitan Omaha Medical Society
Nebraska Medical Association
Nebraska Academy of Otolaryngology
William F. House Society
The Ear Foundation Alumni Association
Prosper Meniere Society

Howital, Appqlnt!Jl.ont§:
Previous:
Baptist Hospital- Nashville, Tennessee
Meharry Medical Center- Nashville, Tennessee
St. Joseph Hospital- Omaha} Nebraska
Bryan Memorial HospitaJ -Lincoln Nebraska
Immanuel Hospital- Omaha, Nebraska
Boys Town National Research Hospital- Omaha, Nebraska
Current:
Bergan Mercy Hospital .. Omaha, Nebraska
Bishop Clarkson Hospitaltfhe Nebraska Medical Center - Omaha, Neb1·aska
Children's Hospital .. Omaha, Nebraska
Methodist Hospital - Omaha, Nebraska
Memodal Hospital .. Fremont, Nebraska

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Committe£S- PosttiQUif {Past & Present) x
Board ofD1-eotors- NB Mealcal Association
Vice Speaker House of Delegates- NB Medical Association. 2004 ~
Board ofDJrectors- Metro 011\aha Medical Society
President- Metro Omaha Medical Soclety 2003
President Elect~ Metro Omaha Medical Society 2002
Nebtaska Delegate to the Yow1g Physicians Section - AMA 1996-1998
Medical Executive Conunittee- Chlldren•s Hospital 2003~2006
Metropolitan Omaha Medical Society Oelegate ·Nebraska Medical Association 1993~
Present
Commission on Society Affairs Chainnan- Metropolitan Omaha Medical Society and
Nebraska Medical Society 1996-2002
Credentials, QI, Peer Review Commlttee- Paramount Group- PPA 2001
Alternate Delegate- AMA 2001
Hope Medical OutJ:each Executive Board 2003w2004
Executive Committee - Metro Omaha Medical Society
Nebraska Medical Association ~ Legislative Committee
Nebraska Medical Association • Socie~ Affairs Committee
Caucus Chairman ·Metro Omaha Medtcal Society to the NMA 2000 • 2002
Chairman Surgical Services - Children's Hospital 1997 - 1999
Universal Newham Hearing Screening Committees at Methodist Hospital and Nebraska
Health System
State of Nebraska Dept of Health & Human Services~ Committee on Development &
Implementation ofUniversal Newborn Hearing Screening Program
Civic fnvolvement

Board of Directors -Omaha Chamber of Commerce
Board of Directors- Omaha Safety Council2004 Board of Directors - Catholic Charities - Omaha NE 2004Archbtshop's Committee for Development
Benefactor - Conception Abbey Cathedral Renovation
Lector - Christ the King Church
.
Chairman - Christ the Ktng Educational Trust Ditmer 2000
Aksarben Buyers Club- Aksarhen 4-H Show
Float committee Aksarben Ball
Omaha Hearing School Board -Past President
West Omaha Rotary -Past Secretary
EqueStrian Order- Knights of the Holy Sepulcher

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3

4

Sclent!fis £res~n.t!Jtions;
American Academy of Otolaryngology-Head and Neck Surgery Annual Meeting. Chicago, IL.
Hmmartomas - Developmental Tumors of the Head and Neck".

11

Trlological Society (Eastern Section), Toronto, Canada, January, 1989 "Radiographic Diagnosis,
Surgloal Treatment, and Long Term Follow-up of Cholesterol Granulomas ofthe Petrous Apex".
Temporal .Bone Dissection Course, The EAR Foundation, Nashville~ TN, October, 1989
"Tympanic Membrane Grafting Techniques11 •
Chronic Ear Surgical Dissection Course, The EAR Foundation, Nashville, TN. December, 1989
11
Compllcations of Otitis Media".
Chronic Ear Surgical Dissection Course, The EAR Foundation, Nashville, TN, Februazy, 1990
"Intact Canal Wall Tympanoplasty".
Tem~oral

Bone Dissection Course, The EAR Foundation, Nashville, TN, March, 1990
"Oss1cular Reconstruction".
Temporal Bone Dissection MJnl Course, The EAR Foundation, Nashville~ TN. April, 1990
"Controversies in Otology".
·

American Neurotology Society, Palm Beach, FL, April, 1990 11 An Analysis ofthe
Reno labyrinthine Versus the Retrosigmoid Vestibular Nerve Section''.
Triological Society (Middle Section Meeting), Milwaukee) WI, January, 199l .. Postoperative
Radiographic Evaluation After Acoustic Neutoma and Glomus Jugulare Tumor Removal
11

•

North American Skull Base Society Meeting, Orlando, FL, February, l99l"Neurotological Skull
Base Surgery for Lateral Skull Base Tumots With Intracranial Extension".
American Otologic Societyy Waikoloa, Hawaii. May, l991 11Transcochlear Transtentorial
Approach for Removal of Large CerebellopontJne Angle Meningiomas".
American Academy of Otolaryngology-Head and Neck Surgery Annual Meeting, Kansas City,
MO. September, 1991. Instructional course "Laser Applications in Otology-Neuroto1ogy11 •

American Academy of Otolaryngology-Head and Neck Surgery Annual Meetin~, Kansas City.
MO, September, 1991. John Conley Lecture - "What I Would Do Differently If I Were Going
Into Practice Today":
Tempotal Bone Dissection Course, The EAR Foundation. Nashville, TN, October, 1991
"Evaluation and Treatment of Facial Paralysis- Controversies in Otology.''
Triological Society (Middle Section Meeting}, Cleveland, OH. January, 1992 11Treatment of an
Acoustic Neuroma in an Only Hearing Ear: Case Report and Consideration for the Future.
Temporal Bone Dissection Course, Midwest Ear Institute, 11 Chronic Ear Swgery", Kansas City,
MO, May, 1992.

Amel'ican Academy of Otolaryngology-Head and Neck Surgery Annual Meeting, Washington,
DC, September, 1992. Instructional eourse "Laser Applications in Otology~Neurotology''.

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American Academy of Otolaryngology-Head and Neck Surgery Atmual Meeting. Minneapolis
MN, October 4·6, 1993. Instructional course "Laser Applications in Otology-Neutotology". '

5

Intet:science Conference on Antimicwbial Agents and Chemotherapy ~ Poster presentation.
"Middle Ear Fluid Concentrations of Cefixlme in Acute Otitis.'' Orlando, Florida., October 4~7
1994.
'
Nebraska Academy of Family Physician Annual Meeting- ''The Evaluation and Treatment of
Newbom Hearing Loss.n Omaha, ~E March 31,2005
Amel'ican Neurotology Society- ''Hands~On Hearing Aids: Wbat the Otolaryngologist Needs to
Know., Los Angelos, CA, September 24, 2005
~ientiflc Pq,bliCJ\,tiO!!§l

Thedinge1· BA, Nadol JB, Montgomery WW, Thedinger BS. Greenburg :JJ: "Radiographic
Diagnosis, Surgical Treatment, and Long Term Follow-up of Choleste1·ol Granuloma ofthe
Petrous Apex", Lanngoseopo, 22:896-907, 1989.
Rauch SD, Merchant SN, Thedinger BA: "Meniere's Syndrome and Endolymphatic Hydrops: A
Double Blind Temporal Bone Study", Ann O,tol Jlhinol~arvm:;Q!, 2.6,(10), 873-883, 1989.
Jackson CG, Cueva RA, Thedlnger BA, Glassco.ck ME: "Conservation Surgery for Glomus
Jugulare Tumors: The Value of Early Diagnosis", Lanu_goscone. JJ!!l(10):1031-1036, 1990.
Glasscock ME, ThedJnger BA, Cueva RA, Jackson CG: "An Analysis of the Retrolabyrinthine
Versus the Retrosigmoid Vestibular Nerve Section'' Otolaa;n. Head & Nee{< Surg, 104(1): 8895, 1991.
Jackson CG, Cueva RA, Thedinger BA, Glasscock ME; 11Cranial Nerve Preservation in Lesions
ofthe Jugular Foramen". Otolanngolo&V-Uet)d li Neels §urgm, ~(5), 687-93, 1991.
Thedinijer BA, Glasscock ME, Cueva RA & Jackson CG: 11Postoperative Radiographic
Evaluation After Acoustlc Neuroma and Glomus Jugulare Tumor Removal" J.,atyogoscQp§,
!!!(3): 261-266, 1992.
Thedinger BA, Glasscock ME, Cueva RA: "Transcochlear Transtentorial Approach for Removal
ofLarge Cerebellopontine Angle Meningiomas": Accepted tbr publication, Apterican.Jvnmal
pf Ote.Jogy, 1991.
Bhatt S, Halpin C, Wen Hsu, Thedinger BA, Levine RA) Tuomanen E, Nadol JB: "Hearing Loss
on Pneumoncoccal Meningitis: An Animal Model", Laau,gos~one, ,U1(12), 1285~1292) 1991.
Thedlnger BA, Cheney, ML, Montgomery WW, Goodman M: ''Leiomyosarcoma of the
Trachea", Anll,O.tW, R!dnol LD!"YAA!t: JOQ: 337-340t 1991.
Cueva, RA, Thedinger, BA, Harrist JP. Glasscock, ME: "Electrical Promontory Stimulation in
Patients With Intact Cochlear Nerve and Anacusis Following Acoustic Neuroma Surgery",
Accepted for publication, The f=aryn_goscone. 1992.
Thedinger, BA, Cueva, RA, Glasscock, ME: ''Treatment of an Acoustic Neuroma Jn an Only
Hearing Ear -Case Report and Consideration for the Future. ~aang,oscope, 103 (9): 1992
Thedinger, BS, Thedin er, BA: ''Analysis ofP~tients with Persistent Dizziness After Vestibular
Nerve Section11 , E
ose & Throat Journal, April, 1998

Received 1ime Jun. 16. 2010 1:24PM No. 0185

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Davis, Thomas C, Thedinger, B. A.~ Greene, G. M.: "Osteomas of the Internal Auditory Canal:
A Repott of Two Cases accepted for publication Th.e Am@l'lcaQ Journal ofOtQIOif, 21 (6):
852-856~ 2000,
..

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£oit!lti!k Publlca!fons - T,ex:Jbooks:
Glasscock ME, Cueva RA, Thedinger BA: Th~ Vet:t129 &:pdho.Pk, Raven Press,
NewYotk, 1990.

rost Goduate COUl'S'<§ ~ttended:
Iowa Head and Neck Dissection Course, University oflowa. Iowa City, IA, June1 1987.
American Academy of Otolaryngology-Head and Neck Surgery Armual Meeting, Chicago, IL,
September, 1987.
Second Intemational S}mposimn on the Pathogenesis, Diagnosis, and Treatment of Meniere's
Disease. Harvard University, l3oston, MA, June, 1988.
Temporal Bone Dissection Course~ The House Bar Institute, Los Angeles. C~ October, 1988.
Tdological Society (l!astern Section), Toronto, Canada, January, 1989.
Amplified Heat·ingDevlces Update, 111e EAR Foundation, Nashville. TN, November, 1989.

Second International Conference on Cochlear Implants in Children, Indiana University,
Indianapolis, IN, January, 1990.
American Neurotologic Society, Palm Beach, FL, April, 1990.
American Academy of Otolazyngology - Head and Neck Surgery Annual Meeting, San Diego,
·

CA, September, 1990.

Kansas City Society of Ophthalmology and Otolaryngology, Kansas City, MO, December, 1990.
Trlological Society {Middle Section Meeting), Milwaukee, WI, January~ 1991.
North American Skull Base Society Meeting, Orlando, FL. February, 1991.

Trlological Society Annual Spring Meeting, Waikaloa, HI, May, 1991.
American Academy of Otolaryngology- Head and Neck Surgery Annual Meeting, Kansas City,
MO, 1991.
Trlological Society (Middle Section Meeting), Cleveland, OH, January, 1992
Third International Conference on Cochleat hnplants in Children. Kansas City, MO, February,
1992.
Triological Society, American Otologic Society, American Neurotologic Society Spring
Meetings, Palm Dessert, CA, April, 1992.
.
American Academy of Otolaryngology - Head and Neck Sul'gery Annual Meeting, Washington,
DC, September~ 1992.
American Academy of Otolaryngology- Head and Neck Surgery Annual Meeting, Mitmeapolis,
MN. October 4~6. 1993

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Trlological Society (Middle Section Meeting) Rochester, MN, January 22, 1994

7

Fourth lntemational Conference on Cochlear Implants in Children, New York, New York,
February 4-6, 1994
Trlological Sooiety, American Neurotologlc - Otologic Societies Spring Meetings, Palm Beach,
FL, May, 1996
Triological Society, American Neurotologic ~ Otologic Societies, Spring Meeting, Palm Desert,
CA,May 1995
American Medical Association YPS - Chicago IL June 1996
American Academy of Otolaryngology Annual Meeting September 28 - October 1:- 1996
Washington DC
American Neurotology Society Meeting September 28, 1996, Washington DC
American Medical Association YPS Atlanta OA - December, 1996
Triological Society Mlddle Section, Kansas City, MO January 26-27, 1997
American Aoademy of Otolaryngology Annual Meeting September 9-12,. 1997 San Francisco.
CA
American Neurotology Society Meeting September 9, 1997, San Francisco, CA
American Academy of Otolaryngology Annual Meeting September 1998 San Antonio, TX
American Neurotology Society Meeting September, 1998 San Antonio TX

Trilogical Society - American Neuotologic Society- American Otological Society Meeting·
Palm Desert CA) May, 1999
American Academr of Otolaryngology Head & Neck Surgery Annual Meeting American
Neurotologi¢ Scoetty Meeting New Orleans LA September 25~28, 1999
American Neurotology Society Meeting September 25, 2000> Washington D.C.
American Academy of Otolaryngology¥ Head and Neck Surgery Annual Meeting September 25~
28, Washington D.C.2000
AMA Annual Meeting, June 2001
AMA Advocacy Meeting, March 2002
American Neurotology Societyt AAO-HNS Meeting, September 2002
AMA Advocacy Meeting, Washington D.C., March 2003
AMA Annual Meeting, Chicago, June 2003
North Central Medical Conference •~Emerging Issues'' Minneapolis MN November 1~2, 2003
CO PIC Risk Management, Omaha November 4, 2003
UCLA Hands,On Comprehensive Stereotactic Radiosurgery Bel Air CA April 13 -15, 2004

Rete ived Time Jun. \6. 2010 1:24PM No. 0185

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Triloglcal Society, American Neurotological Society, American Otological Society Scottsdale
AZ May 1..2, 2004

8

Tri1oglcal Society, Amerlean Neurotological Society) American Otological Society San Diego
CA May 3-6, 2007
'rrilogical Society, Middle Section Chicago IL Jan 19"20, 2008
American Academy of Otolaryngology- Head & Neck Surgery, American Neurotologic &
Otologic Society Meeting, New York, New York, September 18-22, 2004
American Medical Association, Interim Meeting Atlanta GA December 4~6. 2004
American Neurotolgy Society and the Annual American Academy of Otolaryngology - Head and
Neck Surge})' Meetings, Los Angeles. CA, September 24 -27, 2005
~~dures

to Hosnltal Sj!\ff and ptbers:

Medical Staff and Organization Lectutes

Occupational Health Nurse Association, Massachusetts Eye and Ear lnfinnary, Boston, MA,
March, 1987, "Ear Emergencies''.
Bill Wilkerson Hearing and Speech Center, Nashville, TN, April, 1990, 11The Medical and
Surgical Treatment of Meniere's Disease",
Department ofNelU'ology- Neurosurgery Grand Rounds, Methodist Hospital~ Omaha, NB,
October, 1990 "ABRand CPA Tumors''.
Crei~ton University

School of Medicine Lecture 11 Facial Nerve", Introduction to Clinical
Medicine Course, Omaha, NE, October, 1990 & 1991.
AMI St. Joseph Hospital, Operating Room Nursing Staff Grand Rounds, Omaha, NE, ..Acoustic
Neuroma''• November,l990.
University ofNebraska Medical Center, Department of Otolaryngology Gtand Rounds, 11Hearing
Preservatron and CPA Tumors11 , November, 1990
University of Kansas Medical School, Kansas City, KS, "Ear Anatomy", December, 1990.
Creighton University School of Medicine, Neurology Department Grand Rounds, Omaha, NE>
January, 1991.
Creighton University School of Medicine, Medicine Department Grand Rouuds, Omaha, NE,
"Evaluation of the Dizzy Patient11 , March, 1991.
University ofNebraska Dental School, Lincoln, NE, May, 1991 "Otologic Disorders in the
Craniofacial Child".
Creighton University School of Medicine, Surgery Grand Rotmds, Omaha, NE, May, 1991
"Otologlo/Neurotologic Surgery''.
Clarkson Hospital, Family Practice Grand Rounds, September, 1991, "Audlometry11 •

Mary Lanning Hospital Medical Staff Orand Rounds, Hastings, NE, November, 1991 "Analysis
of the Dizzy Patient",
Ctru:ksonHospital, Surge1-y Department Grand Rounds, Omaha, NE, December, 1991, "Otologic
Neurotologic Surgery".

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District 66 Public Schools> Audiology and Speech Pathology Department Meeting, Omaha, NE,
March, 1992, "Hearing Loss and the Cochlear Implant11 •
Cl'eighton University School ofMedicinel Family Practice Department Grand Rounds, April>
1992, ''The Dizzy Patient11 •
University of Nebraska Dental School, Lincoln, NE, May,
Craniofacial Child•'.

1992~

"Otologic Disorders in the

Children's Hospital Pediatric Grand Rounds, Omaha, NE, May. 1992, 11Education of the Hearing
Impaired and the Cochlear Implant11 •
Creighton-Nebraska Dept. ofNeurology Grand RoiDlds, Omaha, NE, July, 1992. ''Cochlear
Implant ~ A New Treatment for Profound Bilateral Sensory Neural Hearing Loss".
University of Nebraska Medical School, Omaha. Nebt·aska, Fall 1992. First Year Medical
Students • Introduction to Chemical Medicine .. Group Facilitator.
Harvard University- Alumni Meeting of the Massachusetts Eye and Bar Infinnary, Department
ofOtology~Laryngology, Boston, MA. October, 1992, "Deaf Education and tile Hearing Impaired
Child''.
Clarkson Hospital Family Practice Grand Rounds, Omaha, NE, November, 1992, "Facial

Paralysis".

Good Samaritan Hospital Grand Rounds, Kearney, NE, Januruy 1993, "Vertigo 101".
Bergan Mel'cy Hospital Orand Rounds, Omaha. NE, February, 1993~ "New Methods for
Evaluating and Treatlng the Vertiginous Patient''.
Oood Samaritan Hospital Grand Rounds, Kearney, NE. May, 1993, ''What is a Cochlear
Implant11 •
Greater Omaha Self Help for the Bard of Hearing monthly meeting Omaha, NE. September 14,
1993, 11What's now in the ear field".
Metro~olitan Community College School

of Allied Health- Nursing, Omaha, NE November 9,
1993. 'Otitis Media and Otologic Dysfunction Related to Allel'gynmmunology11 ,

Department of Pediatrics Grand Rounds - Methodist Hospital, Omaha, NE Januaty, 1994,
"Otoacoustic Emissions".

"The Noon Show" KMTV .. Channel3, Omaha, NE February 9, 1994 "Hearing Loss,

-Amplifleatio~ Hearing Aids, and Cochteftf Implants

11

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Oncology Conference .. Head and Neck Tumors, Bergan Mercy Hospital, Omaha, NE February
18,1994
Three in the MornJng Show" KMTV • Channel 3t Omaha. NE March 9, 1994 "Discussion of
Otitis Media, Thbes, and Live Surgery of Bilateral Myringotomy Wld Tubes".
11

University ofNebraska Dental School, Lincoln. NE MB.t'ch 16, 1994 11 0tologic Management in
Children with Craniofacial Anomalies".
Clarkson Hospital Health & Wellness Club, "Heating Loss" What•s new in the evaluation and
treatment••. September 1994.

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University of South Dakota Department of Communication, "Update on Cochlear Implants in
Adults and Children Seminar". Vennillion, South Dakota, September24, 1994.

10

Midwest Clinlcal Society, 11 Faoial Paralysis Evaluation and Treatment". October 5, 1994.
Grand Rounds Bergan Mercy Hospital 11 When to be Concerned About a Hearing Loss'',
September 15, 1995
Grand Rounds Clarkson Family Practice "Otologic- Vestibular Disorders", January 18, 1996
Grand Rounds Children's Hospital ..New Algoritlnn for the Treatment of Otitis Media", January

26, 1996

Clarkson Health & Wellness Club "Hearing Aids and Hearing Loss 11 , February 8, 1996
OPPD Supervism:s Meeting

11

Noise~ Ears. Hearing Protection",

February 13, 1996

Pfizer Lecture "New Algorithm for the Treatment of Otitis Media'', February 14, 1996
University of Nebraska Audiology Department ..Otology for the Audiologist", February 22. 1996
Orand Rounds Annual Asthma Lecture Bergan Mercy Hospital, "Otitis Medin with Effusion and
Asthma", March 8, 1996
Traumatic Brain Injury Seminar "Balance Djsorders Following Head Injuryn Novernbet 22, 1996,
OmabaNE
University of Nebraska Audiology Department • ''Otology-Neurotology for Audiologists"
Lincoln NE, November 26, 1996
Alegent Health Immanuel Medical Center~ Primary Care Update "Ear Emergencies &
Omaha, NE - Februmy 28~ 1997

Di~iness"

Clarkson Family Medicine "Vertigo" Mal'ch 7, 1997
h

Clarkson Family Medicine "Mylingotomy/Adenoidectomy in Odtis Media"- March 21, 1997
Grand Rounds Children's Hospital "Universal Newborn Hearing Screening" July 21, 1998
Clarkson FIUtilly Medicine "Common Otologic Problems" September 15~ 1998
Metllodist Hospital Family Practice Conference ''Making Sense of the Dizzy Patient, November
6, 1998
Perinatology Conference - Oood Samaritan Hospital, Kearney NE "Implementation of a
Universal Newborn Hearing Screening l>rogtam", September 16, 1999
Methodist Hospital- Neurology Symposium October 27) 2000
Clarkson Family Practice Grand Rooods , Newborn Hearing Screening, November 1. 2000
Creighton University- Neurology- Neuropthomology Orand Rounds, Vestibular Disorders and
Nystagmus, November 3, 2000
University ofNebraska Barclay Center Audiology Grand RoWlds , New Theories and Treatment
of Tinnitus, Novernbet· 2000
Clarkson Family Medicine- Otologic- Vestibular Disorders. lune 2001

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II

Methodist Hospital- Neurology Symposium- Treatment of the Dizzy Patient, October 2002
Good Samaritan Hospital- Grand Rounds - Vestibulal' Disorders September 2003
Methodist Hospital Neurology Symposium- Vertigo/Dizziness, October 16,2003
NE Chapter of Academy ofPedia1rlcs- Organized Medicine, October 17, 2003
Kiwanis Club- New Heal'ing Aid Teclmology, October 21, 2003
Chamber of Commerce Executive Institute Program- Healthcare in Ontaha1 November 4, 2003
Chukson Family Medicine Orand Rounds- "Ear Problems, September 1S, 2004
Oran.d Rounds Children's Hospital - Early Intervention and Management of Hearing Loss in
Children -October 29, 2004

Grand RoWlds -Prairie Pediatrics Sioux City IA ~ Early Intervention and Management of
Hearing Loss in Children November 3, 2004

Methodist Hospital Neurology Symposlum Vestibular Disorder November 18, 2004
Grand Rounds- Oood Samaritan Hospital, Kearney, NE September, 30, 2005- An Otology
Potpourri.
02-08

Received Time Jun. 16. 2010 1:24PM No. 0185

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