Cochlear Implants

Your Child Has Been Recommended For a Cochlear Implant – What’s next?

Your child has completed the evaluation process for a cochlear implant. The Cochlear Implant Team has decided that he or she is a candidate for this procedure. As parent(s), you have made an informed decision for your child to have this surgical procedure.

Please be sure your child has had all necessary immunizations (shots). This includes the pneumococcal vaccination (Prevnar 13®). This recommendation comes from Department of Health and Human Services – Centers for Disease Control and Prevention (CDC). Your child will also need another vaccine, Pneumovax 23, before or just after surgery. This is one of the recommended vaccinations for people who receive cochlear implants. You can ask your child’s primary care doctor or managing ENT doctor to give the shots he needs.

For more information on the pneumococcal vaccination from CDC, click here.


Your child is going to have surgery at the hospital. You may have concerns and questions about this surgery. Many hospitals offer tours of their Surgery Centers. Click here to download a copy of the parent surgery guide for more information on the Nationwide Children’s Hospital Surgery Center and Surgery Unit.

Cochlear Implant (CI) Surgery

The CI surgery is usually done as an outpatient procedure. Sometimes an overnight stay in the hospital may be needed. The surgical incisions heal in 3 to 5 weeks. Children may resume their normal

activities within a day or two after surgery. There may be a little discomfort after the surgery.

What to Expect From Surgery

“Anytime someone we love goes into surgery, it’s scary. But, you know you’ve made this decision with your child’s best interest in mind.”

-Quote from a parent

Day of Surgery

Your child will need general anesthesia for the implant surgery. The operating room or medical staff may update parents during the surgery. After surgery, your child will be going to recovery where the nurses will monitor him or her. The implant surgeon will speak with you to discuss your child’s surgery. Before discharge, you will be given verbal and written instructions for your child’s post-surgery care. You will also see a CI audiologist the day of surgery who will give you some information concerning the cochlear implant and follow-up appointments.

After Surgery

The implant surgeon will send your child home with specific written instructions such as: incision care, signs to look for in case of infection, and medicine instructions. If there are any concerns or problems, you will be given a contact phone number on the Post-Operative (Post-Op) instructions. Your child will have an appointment in about one week to be seen by his implant surgeon. The surgeon will examine the implant site and incision prior to or one week after activation.

At home, your child will be resting and will need time to recover. He will need to stay out of daycare or school for several days. Do not be surprised if your child gets back to being his usual self within a few days. Many parents are amazed to see their child bounce back so quickly!

Cochlear Implant Activation

Approximately 2 weeks after implant surgery, the cochlear implant is activated or turned on by an audiologist who is trained in MAPping cochlear implants. These few weeks allow the swelling to go down and the incision to heal completely before the audiologist does the first fitting and programming MAPping).

During this visit, the audiologist will give you the external components (speech processor(s) and accessories) for your child. The audiologist will also orient you and your child to the use and care of the equipment. You will be given the following information on your child’s cochlear implant:

  • Basic function
  • Appropriate use and features
  • Proper care and maintenance
  • Basic troubleshooting on the device

Your child’s audiologist will give you a “roadmap” for cochlear implant appointment scheduling. This is when the audiologist will program the CI during the first year of your child’s implantation. Cochlear implant(s) MAPping is different for each child. Continued routine CI follow-up will be needed throughout your child’s life (see NCH Post Cochlear Implant Roadmap).

Here is what some parents had to say about the activation of their children’s CI:

  • “The day of activation was filled with excitement and fear.”
  • “You wait anxiously for the activation appointment. And you hold your breath when your child hears for the first time. You smile and cry at the same time.”
  • “Our son cried at his activation appointment and so many people said that is so sad. But we knew he could hear and that was wonderful.”

Expectations of Your Child

The Day of CI Activation

Children have various behavioral reactions during their first implant activation visit. Some children have a surprised or startled look on their face and may turn to their parents for reassurance. Do not be worried if your child cries at first. Your child is not in pain. This may be the first time he is “hearing” and experiencing sound.

While you are holding your child, reassure him by talking and smiling to make him feel safe. There will be many visits to the CI MAPping audiologist. Your child will become more comfortable during future visits.

When Children Come Home After CI Activation

You may find that your child seems exhausted during the first weeks of activation and may require more rest. Remember this is a new experience for him. “Hearing” is new for your child’s brain. The brain is learning to make neuro pathways and connections and is adjusting to this new sensory process.

Post Cochlear Implant Services and Follow-up

Cochlear Implant Program Available Services:

ENT implant surgeon

  1. Medical evaluations
  2. Treatment as needed


  1. Hearing evaluations
  2. Cochlear implant MAPping and services

Speech-Language Pathologist

  1. Assessments to determine speech and language development
  2. Therapy to promote oral language

Development weekly or biweekly:

Occupational Therapist

  1. Assessment for balance (if needed postoperatively)
  2. Treatment as needed

Social Worker

  1. Support services
  2. Parent support group

CI Program Coordinator

  1. Coordination and assistance for your child’s CI services
  2. Consultation with early intervention service providers, therapists, and teachers

The following manufacturers have informative and interactive websites:

Follow-up Medical Services for Hearing Aids and Cochlear Implants

The following services are on-going for your child:

  • Audiological Care – Hearing evaluations and assistive technology devices maintenance, hearing aids, Baha® devices, cochlear implant(s)
  • MAPping/ services
  • ENT doctor – Follow-up appointments with medical evaluations and treatments as appropriate