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Oxford University Hospitals NHS Foundation Trust

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Cochlear Implant switch-on and rehabilitation

Approximately two weeks after implant surgery, the cochlear implant sound processor(s) will be fitted and activated. This is called the 'switch-on' appointment.

'Switch-on' appointment

During this appointment you may start to hear sound or feel sensation from your processor(s). People report a range of experiences when the processor is first switched on.

Some people hear beeps or buzzes, some people can hear speech (but it is not yet clear), and some people feel sensation rather than hear sound.

The initial processor(s) settings will be set at a low level, so you are comfortable and can get used to the new sound or sensation. As you adjust to the sound, the settings will be increased at further appointments. This will give you more access to sound.

With young children you may not see a response in the first few weeks. The processor levels are increased very gradually to make sure your child stays comfortable and happy to wear their processor(s) as they adjust to the new sound.

It takes time to get used to listening with a cochlear implant, but wearing it all the time and practising helps. Progress is very individual and linked to many factors such as how much time you are able to wear the processor(s) each day, listening practice and how long you have been deaf.

You will receive a series of appointments for the first 12 months after cochlear implant surgery. These appointments will be with Audiology (for tuning) and Speech and Language Therapy (for auditory training).

We will help you understand the process of learning to listen to this new sound and create a personalised plan of rehabilitation for you or your child.

Making the most of hearing with your cochlear implant(s) takes time and practice and we are here to support you in this journey.

Everybody is different and outcomes with cochlear implants vary considerably. We will discuss your or your child's progress with you throughout.

Stages of listening

Stages of listening range from being able to notice everyday sounds through to more challenging listening situations, such as using the telephone with unfamiliar people.

Not everyone will be able to achieve this level of listening, but we will help you with these expectations and help you reach your full listening potential.

The seven stages of listening

1. Detection

Being able to notice everyday sounds with your cochlear implant.

Auditory Training Level 1 - Detection (Word, 92 KB)

2. Discrimination

Being able to tell if two sounds are the same or different e.g. car versus dog, male voice versus female voice.

Auditory Training Level 2 - Discrimination (Word, 87 KB)

3. Identification

Being able to identify what you have heard from a choice, rather than just being able to tell that two sounds are different. This could include being able to point to the word 'Tuesday' from a list of the days of the week.

Auditory Training Level 3 - Identification (Word, 96 KB)

4. Recognition

Being able to repeat back what you hear from a choice of phrases.

Auditory Training Level 4 - Recognition (Word, 89 KB)

5. Comprehension

Being able to listen and understand what you hear. This could include being able to follow an instruction.

Auditory Training Level 5 - Comprehension (Word, 100 KB)

6. Conversation

Being able to follow and take part in conversations. This includes conversations with more than two speakers and conversations in background noise.

Auditory Training Level 6 - Conversatio (Word, 90 KB)

7. Telephone conversation

Being able to use a telephone to talk to people you know and people you don't know.

Auditory Training Level 7 – Listening on the telephone (Word, 87 KB)

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