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What to Expect In the First Weeks After a Child’s Cochlear Implant Activation

August 23rd, 2013 by | Tags: , , , , , , | Comments Off


In the first weeks after your child’s cochlear implant is activated


The big day has finally arrived!  Your child’s cochlear implant(s) are finally going to be turned on.  After months of appointments and waiting, you may feel as if you’ve made it to the finish line, but you are really at the beginning of the incredible journey of teaching you child to hear.



Do you know all of those great YouTube videos of children having fantastic reactions to their CIs being turned on?  What you don’t see are the thousands of other families who took much less impressive videos – the families whose children cried,fussed, or did nothing at all at their initial activation.

Typically hearing children begin to hear twenty weeks before they are even born.  Before a typically hearing child takes his first breath, his brain has already had twenty weeks to organize around the sense of sound.  At the initial activation, your child’s brain is hearing sound clearly for the first time.  It’s like going from a dark room out into the sunlight… and never having seen the sun before.  Your child will need time to adjust.

Typical reactions at initial activation include:

  • Positive reactions: laughing, smiling, turning toward the sound source, etc
  • Eyes blinking, widening
  • Stopping movement when a sound is played
  • Crying
  • Startled/scared response
  • Trying to take the CI processor off
  • Clingy
  • No response at all – this is perfectly alright.  The audiologist can check to make sure the CI is working even if the child does not have a response at the initial activation.  No response at the first appointment does not mean that the CI is broken or that your child isn’t benefitting.  It’s not a cause to worry yet.

REMEMBER:  Your child’s CI(s) will be programmed at a very low setting at the initial appointment and gradually turned up after that.  This is just the beginning, like wading into the shallow end of a pool before jumping off the high dive.



Unlike glasses, cochlear implants are not an instant fix for hearing loss.  Just because the CI is turned on doesn’t mean that your child is hearing perfectly right away.  But it also doesn’t mean that he isn’t making huge progress every day, though it may be invisible to you unless you know what to look for.

Signs of progress in the first few weeks after activation include:

  • Tolerating the CI processor on the head more hours each day, working up to use of the CI all waking hours as soon as possible (remember, if the CI isn’t on, the auditory brain isn’t growing!)
  • Increase or decrease in vocalization when the CI is on (if you can hear yourself babbling, you’re likely to babble more OR if you can finally hear all the noise you’ve been making, you might realize how loud it is and be quieter!)
  • Startling, widening eyes, searching around, stopping sucking when loud sounds occur in the environment
  • Banging toys or other objects to make a sound, experimenting with things that make sounds in the environment
  • Quieting to parent’s voice, singing, or music
  • Tolerating changes in CI programs (the audiologist will give you instructions about how to gradually turn up your child’s CI(s) at the initial activation appointment)

What you can do during these first few weeks (and really, all the time):

  • Respond, respond, respond to these new behaviors and sounds (e.g. bang objects too, imitate his vocalizations, take turns playing with toys that make sounds)
  • When your child startles or appears to search for a new sound, smile and point to your ear to indicate your heard it too, then take your child to source of the sound (e.g. airplane, dishwasher, dog barking, knock on the door,bathtub running, etc.)
  • Talk all the time, about whatever you’re doing, and if you’re not doing anything, talk about what you’re thinking (e.g. “Hmm, what should we have for dinner? I’m so hungry…”)
  • Sing songs that correspond to your daily schedule. They become part of your routine and you won’t have to “remember” to sing (e.g. “Row Row Your Boat” atbathtime, “Twinkle Twinkle” at bedtime, etc.)
  • Pop that processor right back on (sometimes 50 times a day). Children love attention, and we love to give it to them, but when they remove their processor/coil or it falls off, don’t make a huge fuss, just stick it right back on with a quick smile and carry on. This way, your child will learn that his device is truly a part of him and won’t make a habit of removing it to see your response

REMEMBER:  When you see a listening, talking child who is a CI success story, they too were at this very beginning stage at one point in time.  Everyone starts from square one.  If they could get there, so can you!


Special thanks to Katie Pridgen, MS CCC-SLP, for her collaboration on this article.


Written by

Elizabeth Rosenzweig MS CCC-SLP LSLS Cert. AVT is a Listening and Spoken Language Specialist Certified Auditory Verbal Therapist. She provides auditory verbal therapy, aural rehabilitation, IEP advocacy, consultation, and LSLS mentoring for clients around the world via teletherapy. You can learn more about Elizabeth's services on her Website or Facebook.

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