What to Expect On Activation Day

The day you’ve been waiting for is finally here!  After the process of candidacy assessments, choosing a device, and surgery, it’s finally time to activate the cochlear implant.  I’ve written before about what to expect in the first few week’s after a child’s CI is activated, but what should you expect on your child’s activation day?

Expect the unexpected.  By now, you’ve probably watched hours upon hours of YouTube videos that other parents have posted of their children’s cochlear implant activations.  You’ve seen the ones where the child laughs, instantly turns to sound, looks at his mother, bangs on a drum, smiles, and appears to be having the time of his life.  What you haven’t seen are the thousands of other videos taken by parents whose children did nothing on activation day, or cried, or tugged the processor off their ears.  Those aren’t the cute, heartwarming videos that go viral.  Those are the boring, or even disappointing, videos that most likely remain on the parent’s phone until they’re taking up too much space and get deleted.  But you know what?  All of those reactions are perfectly normal, and none of them predict success or failure with the cochlear implant.  Some may be more YouTube-worthy than others, but if your child has ANY of the reactions above, rest assured that that is perfectly expected and not at all a sign that something is wrong.


Remember it’s a slow start.  Activation of a cochlear implant is like coming out of a dark movie theatre into a bright parking lot — it’s a shock and it takes our eyes a while to adjust.  The same thing is happening for your child’s ears and brain on this exciting day.  To make the transition gentler, the audiologist initially sets the cochlear implant at very low levels.  Your child may only respond to loud sounds at first.  Over a series of subsequent appointments, the cochlear implant MAP will be adjusted until your child is hearing at or above the target (able to hear soft conversational speech well in quiet and in noise).  How your child hears on day one is not how he should be hearing in one, two, or three months.  Don’t be alarmed if he doesn’t initially respond to quiet voices or soft environmental sounds.  (DO be alarmed if he’s not doing this in a few months, or if the MAP has not been optimized by then.)


Take a deep breath and take it all in.  You will receive an avalanche of information and equipment at this first appointment.  Cochlear implants may be small, but you’ll be sent home with literally a suitcase’s worth of chargers, spare parts, accessories, and other “gear.”  I advise most families that it’s helpful to bring along at least one other adult as a helper to this first appointment — someone to hold onto the gear, take pictures, write down future appointment dates, and be another set of ears in the room for remembering important information, freeing up the parent(s) to just experience this incredible moment with their child.


Set yourself up for success.  If at all possible, try to get an appointment time during a part of the day when your child is at his best (well fed, rested, clean diaper, etc.).  These initial appointments can take time, so bring along some of your child’s favorite toys, snacks, or books to keep him happy and occupied throughout the session.  Remember to charge up your phones, cameras, and videocameras, too.  You’ll want to capture this moment!


Happy birthday to your child’s ears!  You are at the beginning of an incredible journey.  Remember that every “CI Success Story” once started exactly where you are.  Take some time to reflect and celebrate.  Congratulations!  The fun has just begun.

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