Cochlear Implants

Cochlear Implants

I went to an amazing conference the other day on cochlear implants put on by the Cochlear Foundation. When I finished grad school 7 years ago cochlear implants were still pretty controversial. I never knew quite what to think.

I left this conference deeply impressed that implanting children with a profound hearing loss with cochlear implants as soon as possible produces the best possible outcomes. It was recommended to implant as early as 6 months and when possible putting an implant in each ear virtually restoring their hearing.

Cochlear Implants - Mommy Speech Therapy

I ran into an old friend from college at this conference who is now an audiologist. He told me a story about one of his clients who had been implanted with a cochlear implant at an early age. This little boy was at school one day and the other kids brought up the word deaf. The young boy was born profoundly deaf yet had never heard the word deaf before. He went home and asked his mom what it meant to be deaf. She explained that deaf was what it was like when they turned off his implants at night.

They also had a family come and talk that had three children born profoundly deaf. With the first child they struggled with the decision of whether or not to do a cochlear implant. At the time their deaf friends had communicated to them that cochlear implants were not well received in the deaf community. When they finally decided to get a cochlear implant they had to fight their insurance to get the funding. Finally their first child was implanted at almost three years old. Her first word came about 6 months later. When their second was born profoundly deaf as well they knew they wanted to get a cochlear implant for her as well. She was implanted at about 2. Then they had a third child also born profoundly deaf. The little boy received his cochlear implant at 1 year. They all speak well now but the little boy met his language milestones right along side his hearing peers. He spoke more clearly and with better grammar than his sisters did at an earlier age. While his oldest sister’s voice quality is still a little off the last two you would never know were deaf.

I am definitely an advocate!


  1. Your website is a wonderful resource to parents of kids with cochlear implants! Thank you for taking the time to publish it…

    Kelli, Mom to Landry who was bilaterally implanted one month ago at age 9.5 months!

  2. Heidi-
    I just want to thank you for your generosity and willingness to share information and materials. These things are gifts of great value to struggling parents and indicate that you value people above all else. It’s a great site!

    Grace Gingrich (Teacher of the Deaf and HoH)

  3. Hi Heidi!

    My daughter has a cochlear implant and is about to get her second ear implanted. She was a hearing child and then gradually lost her hearing beginning with high frequency first around 3 years old, she is 9 now. As a result her high frequency sound quality is poor. I have just downloaded your articulation station after doing a long research among other apps out there and can’t wait to start with it, it looks great! My question is what sounds would you recommend that I download. I know we are going to need an “S” for sure. She also has difficulties with “ed” on the end as in “asked” or “worked”. She also has problems with “S” blends. I am noticing that her speech hasn’t been improving with school provided therapy 4 times a week so I wanted to do something fun with my daughter at home that will help her with her articulation. Any help would be appreciated!!!

  4. Hi Olga,

    I would love to hear how your daughter responds to Articulation Station. Please let me know. If you download the s sound program the s blends are included in that program. The other sound program I would suggest to start with would be the t sound program. When you end a word with ed the sound you are saying is a /t/ sound. The /t/ sound is a higher frequency sound because it is voiceless which is likely the reason your daughter struggles with this sound as well. Try working on it in the final sound position of words to start with. Good luck and enjoy!

  5. Hi Heidi,

    Congratulations on your app debut! As a fellow SLP and app developer I can relate, my Auditory Verbal therapy app went live in the app store just yesterday. It’s geared toward new cochlear implant and hearing aid users to check their ability to hear the Ling sounds, a necessary foundation for speech comprehension.

    Here is the link in iTunes:

  6. Congrats Mellisa! I love it. I’m super excited for you!!

  7. Hi Heidi! What a wonderful website and thank you so much for your positive thoughts on cochlear implants! We have a deaf son implanted at 9 months, and after much speech therapy and hard work, he is absolutely flourishing. Not only is he right on track with school, but the implant enabled him to learn other languages like Mandarin, Italian and Spanish. The implant has been an absolute miracle in all of our lives.

  8. Hi Rosa,

    Thank you so much for sharing your sons success with us! I am sure there are many parents that will really benefit from your comment. Take care!

  9. Ladies,
    I would suggest comparing her audiogram to the speech banana. This will help to see what sounds your daughter is missing.

    I am teacher of the deaf and hard of hearing.

  10. Thank you for the great suggestion Michelle!

  11. Heidi,

    I am a Teacher of the Deaf and I use AUSLAN (Australian Sign Language). I would be hesitent to claim that the implant ‘virtually restors hearing’ as this is not the case. I would encourage all parents, teachers and therapists to listen to the simulator to appreciate what sound actually ‘sounds’ like for people who are implanted with cochlear implants.


  12. Hi Heidi,

    MY sister is having a hearing loss of almost 80% and she is currently wearing a siemens hearing aid product. She is 22 years old and has been wearing this since last 19 years. Due to the hearing loss, her speech is also not clear. Can you please let me know if cochlear implants can be a help at this age also? If no, I would really appreciate if you could let me know if there is any thing else that we can do.

  13. Thank you Kelsey for sharing your perspective with us. I have never listened to the simulator myself. I think that is a very wise recommendation.

  14. Hi Sumeet,

    Cochlear implants are typically recommended for people who receive no benefit from hearing aids. Before a cochlear implant is recommended a full evaluation of the ear, as well as extensive hearing tests are done on each patient to determine if they would be a good candidate for a cochlear implant. Adults that are implanted will typically see an improvement in their communication skills overall. If your sister is open to the idea maybe you ought to encourage her to see an Otolaryngologist to determine if it is a possibility for her. However, I would recommend being sensitive to whether it is a concern for her because she may be happy just the way she is.

    If she is interested in working to improve her speech I would recommend seeing a speech pathologist whether she is implanted with a cochlear implant or not.

    All the best!

  15. My son has bilateral cochlear implants. The surgery was early june and his processors turned on at the end of june. Its so amazing to see him responding to sounds and experiencing what it is like to hear. We are starting speech therapy and he will attend school at 2. The school program i chose should have him mainstreamed by kindergarten. 🙂 my son is 19 mos old currently.

  16. Hi Olga. I am a teacher of the deaf and hard of hearing. I am wondering if your daughter has been able to make use of a personal FM system with BOOM microphone. If that is used during therapy sessions and during class too, it may help her improve more with her speech articulation. We have found here that it is best for students to use the my-link receiver (child sized) that hangs around their neck. The ear-level receivers often have static/interference issues because of the magnet causing interference with the FM signal. It is very important to have a boom microphone as it helps significantly with the high frequency information. For more information talk to Peter Stelmakovich at Phonak.

  17. I agree! Your site is a wonderful resource! As a teacher of the deaf and hard of hearing I have found your site to be extremely helpful. THANK YOU! 🙂

  18. Hi Heidi,

    Thank you SO much for your support of cochlear implants and early implantation. It really does make a huge difference in the children’s language development. You would not believe the negative messages that parents who choose implants for their children receive. They need our support. It is very interesting what the little boy said about being deaf. It is true that many children consider themselves hearing when they have cochlear implants. Although they are still deaf, I think it’s important to remember that, they do think of deafness in a completely different way than the traditional definition. One of my former students received cochlear implants as a young teen. He was always very oral with excellent speech articulation but hearing with hearing aids continued to be more frustrating for him as his hearing decreased. Getting implants was completely life changing for him!! He said that with hearing aids he felt he was hearing 2/10, it was just dreadful for him. He said with the implants he was hearing about 7/10 in his opinion. He realizes he doesn’t hear everything but 70% is sure a lot more than 20%!

  19. Hi Kelsey. When I first started teaching the deaf 28 years ago, implants were not an option for children as that was not for another 5 years in 1990. Some of my former students, that I taught when I first started teaching, are now getting cochlear implants in their 30’s & 40’s and are doing well. Certainly people who have oral skills do much better with implants when they are implanted later. The documentaries, “Sound and Fury” and “Sound and Fury 6 Years Later” are excellent. They address this issue about later implantation. It is important to watch both documentaries as the follow-up certainly shows how attitudes change. Parts are hard to watch, and they are rather emotional, but certainly worthwhile. I think they are both on youtube.

  20. P.S. I know someone else who got implants as an adult, and his speech has improved significantly since his implantation. He had normal hearing until he was 6 years old so that would be a factor as well.

  21. That is incredible that your son has been able to learn so many languages!! 🙂 I have seen the dilemma that many parents face when they have to give up speaking their native language in the home, because they need to speak English so their child will do well in school. However with cochlear implants I think this is significantly reduced and it is often possible for a child to learn more than one spoken language.

  22. P.S.!! and wearing an FM at home can also be helpful!

  23. I’m a teacher of the deaf as well. Cochlear implants create an electronic simulation of sound and you are right that they do not “restore” hearing. However, they do provide access to all of the speech frequencies and often people can detect all the sounds in a borderline normal or mild range. This does not mean they have normal hearing, but people often do extremely well with implants. Does it sound like what people with normal hearing hear?…no. However, improvements with processors are happening all the time. I would caution parents not to be too discouraged if they do listen to a simulation. I always think it is good to dwell on the positive where implants are concerned, keeping in mind that they have their limitations. Lives are changed by cochlear implants for the better…there is no doubt about that in my mind!! See my other comments.

  24. Ok, here is another comment, lol. Recently one of my former students was at the World deaf hockey championships in Finland. Years ago, most of the players on the Canadian team were ASL users and Culturally Deaf. Now it’s just the opposite with about 75% of the team either having cochlear implants or hearing aid users. Apparently only 5 fellows on the team are Culturally Deaf. There was a picture of my former student with his teammates. Of the 12 guys in the picture, 4 had C.I.’s, 2 signed, and the rest were hard of hearing (which could also mean deaf depending on how the individuals define their deafness). Interesting eh? Although this is not true for all teams, both Canada and the U.S. have more access to technology and tend to be more oral. All kids need deaf role models who have chosen the same option (whatever that is). Another interesting story is that of JQ DePaiva whose parents are soap opera stars. He received implants as an infant and has been on All My Children when they did a story on C.I.’s. Attitudes are changing, but sadly what we see in the media (e.g. Switched at Birth) is rather one sided in presenting all deaf people as signing. I would like a healthy balance and I’m sure others agree with me.

  25. My boyfriend’s son has bilateral cochlear implants. He has had them for over a year now. he will be 4 yrs. old next month We recently just moved in together and I notice he doesn’t understand when your asking him a question. I find he wants to repeat what you say. we have started potty training him and he is doing good, but when I ask him if he has to potty, he tends to just repeat me. any suggestions on what I can start doing with him to help him start distinguishing when your asking him a question and when your talking to him?

  26. Hi Jenn,

    You’re boyfriends son may be repeating you for a number of reasons. He may still be trying to figure out the meaning of words and is fascinated with how they sound and may be trying to imitate your speech so he can learn to speak clearly like you. Or it may be that he has more going on than just a hearing loss. The first thing I would recommend is that you contact his speech pathologist (if he doesn’t have one make an appointment right away to get him started on speech therapy) and share your concerns. Then together you can create a plan to improve his speech and language skills.

    In the meantime, I would set aside 20-30 minutes every day where you play with him, labeling everything in his environment. Don’t ask him any questions during this time, just let him repeat you or add to what you are saying. Then when it is time to clean up practice giving him a few simple directions that he can follow. For example, you might say, “It’s time to clean up. Put the dinosaur in the box.” Then observe him to see if he can follow this direction. If he doesn’t do it prompt him by pointing to the dinosaur and then pointing to the box while repeating the direction. If he still doesn’t follow through then take his hand and help him pick up the dinosaur and put it in the box while saying, “Put the dinosaur in the box.” Then reward him by telling him, “Good job! You put the dinosaur in the box.” This little exercise will help you determine if he is able to follow directions.

    To teach questions I would start by giving him simple choices. You might start when you get him dressed in the morning. You might say, “Do you want to wear the red shirt or the blue shirt?” If he repeats the question instead of answering it then hold the blue shirt up and say, “blue shirt?” Then hold the red shirt up and say, “red shirt?” If he answers your question reinforce his response by saying, “the blue shirt” and then put it on him. You can use choices at meal time, snack time, play time, book time, movie time… As he gets better at answering these questions you can move on to yes/no questions and other more complex questions.

    I hope these ideas help you get started but please be sure to contact your boyfriend’s son’s SLP and work closely with them.

    All the best!

  27. he is in speech therapy 3 days a week. and he goes to daycare the other 2 days. I’ve been asking him questions like where is the table and he just stars at me, then I ask where’s jennifer, and he points to me and says Jennifer, then I ask him where is the table again and he points to the table. That seems to be working pretty good. but my other concern is when he talks he doesn’t open his mouth, he mumbles alot and he will try to tell me something with his teeth closed and mouth just a little open. I know every kid learns at a different speed, I just wonder after going to speech therapy 3 days a week for over a year and a half maybe almost 2 years, should he be able to talk more than he is

  28. Hi Jenn,

    I’m happy to hear he is working with a speech therapist. If you have concerns about his progress I would schedule an appointment with the speech therapist to talk about your concerns. Ask her what her thoughts are on his progress and if there is more you can be doing at home to support what he is learning in therapy. Every child is a little different and progresses at a different rate. When children have support at home as well as at school their progress is usually much faster.

    Best of luck!

  29. Hi I am doing a school report on the cochlear Implant and in my research I have found that the external parts cannot get wet. Is this true? If so are these parts detachable for when it starts to rain or you want to go for a swim, or are your activities limited by these parts not being detachable? Thanks

  30. hey
    my daughter 3.75 years has been cochlear implanted 1.9 years ago…and has been going for the speech therapy from 1.2 years since we were not getting any good speech therapist…..she is going to the nursery as well and well settled …well behaved girl and pottey trained as well….i just wanted to know that she says alot of words as well and most of the time understand instructions as well…but she repeats alot of words and dont speak much as she has to speak….i m worried please help

  31. I am an Early Interventionist (Play Therapist) with the NC Early Intervention Birth-3 program. I do individual therapy with all developmental needs children and also do a play therapy group 1 day a week for kids that need that extra socialization. I have done individual therapy with a child that had a cochlear implant, and it went well. We have a new child in our play therapy group that has a cochlear implant. We are having a time with him considering his developmental milestones are different than the other kids. He will not play with his peers in group during free play. He does well at snack time and today did well during the art activity. He refuses to sit in circle time while we read books, songs, finger plays, etc. He is pulling toys off the shelves and throwing. Today we took all the toys off the shelves while we did circle time. Dad has tried to leave the room but once he notices dad is gone he starts signing dad and becomes extremely upset until he comes back in. Nothing works trying to get him focused on something else to calm down. He throws toys which he is redirected just like the other kids. When he becomes upset he will jerk his processor off and throw it. Its really hard with 6 other kids in group. he needs the one on one attention more but we can’t give that all the time in group. I teach the group and have an assistant that helps me. Just wanted some other ideas from others that have more experience then me with cochlear implants that we may be able to use.
    Thank you,

  32. Hello
    I have a daughter almost 4 ….she had a profound hearing loss and cochlear implanted at the age of 2 years 2 months….she is being going to the speech therapist as well from one year …but are not getting results which we want…she says alot of words …follow most instructions as well …repeat almost every thing but according to her speechshe is therapist she should b saying sentences by now…she is fully pottey trained as well …going to nursery as well….according to my thinking she started listening after 2.2 years she will take time accordingly…what do u say ? please help…

  33. Hi Jesse,
    Sorry for the delay in response. From the information we have available, the internal part of the cochlear implant will not be affected if a child with a cochlear implant were to go swimming, or be out in the rain etc. The external part of the cochlear implant can be taken off or there are accessories available to help protect the processor component from getting wet. Thank you for your question!

  34. Hi Urooj,
    Your daughter may be repeating you for a number of reasons. She may still be trying to figure out the meaning of words and is fascinated with how they sound and may be trying to imitate your speech so she can learn to speak clearly like you. Or it may be that she has more going on than just a hearing loss. The first thing I would recommend is that you contact her speech pathologist (if you’re not happy with her current one, maybe seek a different one out if possible) and share your concerns. Then together you can create a plan to improve her speech and language skills.

    All the best!

  35. Hi Tammy,
    Sorry for the delay in response. I’m sorry to hear that this new little guy is having a hard time in your group. To me it seems understandable that he might be exhibiting some difficult behaviors since he is developmentally delayed, he has a cochlear implant that I presume he’s still getting used to, and he is in a new environment (your group). I can also understand that his behavior makes it difficult for you to conduct the group with the rest of the students. My suggestion is to give him some time. It will take awhile for him to adjust to a new environment and to know what the schedule is, and what is expected of him. Also, and I’m sure you probably already have this in place but it’s worth mentioning–make sure that you are using positive reinforcements for when he does exhibit good behavior and he does follow the schedule. That might be something like a token reward system. Every time he listens or follows the schedule, give him a token, or a small piece of food (fish cracker, m&m, etc. whatever is motivating to him) so that he is positively reinforced for that good behavior. It might also be beneficial to have a visual schedule posted for him and the class so they know what activities are coming up next and so they can be prepared for upcoming transitions. Behavior training through the use of video modeling or social stories have also been shown to be effective. Good luck! Difficult behaviors always make intervention more difficult, but through some planning and finding what works for the child you can put a successful behavior system in place to help aid him through therapy group.

  36. Urooj,
    I agree with you, her language skills are most likely delayed due to the fact that she had a profound hearing loss. I think that you are doing her a great service by having her seeing a speech therapist. Progress may be slow, but it sounds like she is making progress if she is saying words, following instructions, and even repeating what she hears. Continue to model good language for her. Have her repeat small phrases or short sentences after you. Continue with the speech therapy, and she will most likely progress into the sentence level with all the good intervention going on around her. Good luck!