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


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” at bathtime, “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

  • Get connected with a Listening and Spoken Language Specialist, Certified Auditory Verbal Therapist.  You need an expert coach and guide by your side to help you learn to build a bright future for your child.  For children with hearing loss, not just any SLP will do.

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.

5 thoughts on “What to Expect In the First Weeks After a Child’s Cochlear Implant Activation

  1. Thank you for this article. Are there articles about what to expect, YEARS after getting the implant?
    Our son Rafael was born severely deaf, able to hear only above 90 decibels. He got his first cochlear implant two months after his second birthday, and his second implant about 6 months after that. As soon as he turned three we started him in a special public school for the deaf and blind, where he is subject to a thorough curriculum and weekly therapy sessions — supposedly. It has been three years and he still behaves like a deaf person. The problem is, I’m the only one who thinks this. Everyone else, including my wife and therapists, all claim that he hears perfectly and that in fact sign language would now be a hindrance as we try to get him to respond more from a voice than from lip reading. I am the party pooper and my attitude is not helping; therefore I have basically been rendered to silence while I watch my son’s life passing by. Sure, he speaks one or two stock sentences and a few separate words, but these had been drilled into his brain repeatedly, it still sounds forced (like a deaf person), and he has not yet made up his own sentences. You just need to put him in a room with other kids, and you will notice he does not respond to his name, it is difficult to get his attention with sounds — sometimes he does not even react to sharp, loud noises. His four siblings had basically given up on him, despite all that we have done to teach them how to help with his therapy, because he just does not respond to what they say.
    So as it stands, everyone is telling me to basically just talk to him and just trust, without any evidence, that he can actually hear.
    My fear is that one day — what, when he turns 12? — one day, everyone will finally find out that he actually has been deaf all these years, that his hardware had not been working, long after his entire childhood already passed. I am all alone in this fear. Any pleas from me for a second opinion fall on deaf ears (sorry for the pun, but that’s the truth) and I am forced to stand by helplessly while the years pass by.
    Just… please tell me all of this is somehow normal, to have implants for three years and still behave like this. — AAG

  2. My child’s CI was activated just 24 hours ago, and she gave very little reaction at the activation. I was incredibly anxious about this and our AV therapist and audiologist assured us that this was normal; however, my partner and I still obsessed about it. I feel a bit better after reading your article. Thank you.

  3. Thank you for your comment, John. I’m so glad to hear that this article was helpful to you. I wish your daughter much success as she begins to learn to hear with her cochlear implant!

  4. Hi
    I just read your article and it’s really helpful
    I got my son’s CI activated today 10 hours ago and his response was very little… Or even if it was his response to sound in the first place I don’t even know I m extremely worried although audiologist said it’s not to worry about but I can’t help myself obsessing and after searching online I came across your article. It’s really helpful but can you please tell me if you yourself has ever seen a case of baby with no response In the beginning and how long will it take for them to respond normally
    Thanks a lot for such a helping article

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