Cochlear Implant Program Activation

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Contact the Cochlear Implant Program

Activating your child’s cochlear implant

Your child has completed the cochlear implantation process and is now ready to begin her hearing journey. Our dedicated and expert team will follow her every step of the way.

How soon will my child be able to "hear"?

Three to four weeks after the surgery, your child will visit with an audiologist for the first “stimulation” using the speech processor. Activation of the speech processor requires two, 2-hour appointments within one week.

During these appointments, your audiologist will assess your child's responses to help determine how much current each electrode should deliver. The audiologist may also use neural response recordings to program the device to give sound sensations that are just loud enough to be heard and comfortable. This is called a "map" and appointments such as these are called "mapping" appointments.

After the initial mapping, the child is seen for re-mapping and fine-tuning at:

  • one month post-activation
  • three months post-activation
  • six months post-activation (including hearing testing and a speech-language follow-along)
  • then every three months, typically for the first year or two

What will my child hear when the implant is activated?

Because only your child knows what she hears through a cochlear implant, we have to rely on what she tells us it sounds like.

Many older children tell us it sounds like static or buzzing or high-pitched squeaky sounds when it is first activated. Regardless, in most cases your child will not understand speech when the processor is first turned on. Months-to-years of listening therapy is typically required to help your child's brain make sense of the sounds it is receiving. This is especially true for children who lost their hearing at birth or before hearing spoken language, who receive their implants very young and for children with limited spoken language abilities who receive them later.

Please refer to the "Additional Resources" page for simulations of what science tells us a cochlear implant might sound like.

What factors might favor or limit my child's benefit from a cochlear implant?

Most children who receive cochlear implants do enjoy some degree of benefit. Goals and expectations for the outcome of cochlear implantation vary for different children and are reviewed thoroughly with the family before the surgery.

Factors to promote maximum benefit using a cochlear implant:

  • favorable cochlear anatomy
  • surgery at a young age
  • a solid base of language development prior to surgery (age-appropriate)
  • a high level of motivation and commitment on the part of the family to keep frequent appointments, maintain the device and encourage listening skills
  • an appropriate educational program which incorporates listening activities into the curriculum
  • regular speech/language therapy given by a clinician with specific expertise and experience in the area of spoken language development in deaf children using cochlear implants

The benefit from a cochlear implant may be limited by a child's previous language deprivation or by a particular child's disorder in language acquisition skills. The anatomy of the child's ear and auditory nerve also may limit sound reception and clarity with an implant. Illnesses such as meningitis may also impact the success of a cochlear implant.

Should my child use sign language with an implant?

Once implanted, children with early access to sign language often begin understanding spoken language earlier than those with no early language stimulation. Children may continue to use sign language as long as it is beneficial. Once implanted, even for children who use sign language, continual opportunities for listening and developing understanding of spoken language should be provided throughout each day to maximize benefit using the cochlear implant.

We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”
- Sandra L. Fenwick, President and CEO

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