Who This Page Is For
This “Start Here” guide is especially helpful if you are:
- Preparing for cochlear implant surgery or activation
- Newly activated and adjusting to sound
- A caregiver, parent, spouse, or family member looking to support a CI user
- A long-term user looking to improve clarity and confidence
- Anyone searching for trustworthy, easy-to-understand CI information
Understanding the Cochlear Implant Journey
A cochlear implant is one of the most incredible inventions of our time, but it doesn’t “hear” for us. It simply opens the door to sound again so that sound can get to the brain where it can be processed in hearing centers. If the door analogy is too complex, think of a cochlear implant as a bridge. Hearing loss prevents the brain from fully accessing sound, and the cochlear implant works like a bridge to fill in that gap.
Because the cochlear implant is making a way for sound to be processed in the brain (sometimes for the first time in a long time if there was hearing loss for several years), it means:
- At first, voices may sound robotic or unclear
- Background noise can feel overwhelming
- The brain needs time, repetition, and practice (more on how to do this later)
- Progress looks different for everyone
Parts of a Cochlear Implant
Let’s first break down the parts of a cochlear implant in simple language so we can better understand how this all works. There are parts of the cochlear implant outside the body (external parts) and parts of the implant that are surgically placed under the skin (internal parts).
External Parts: Microphone, Speech Processor, Transmitter
Internal Parts: Receiver/Internal Processor, Electrode Array.
- Microphone: The microphone captures sound and sends it to the speech processor
- Speech Processor: A little computer that takes sounds picked up by the microphone and turns them into digital signals that the implant can understand.
- Transmitter: The transmitter receives the signals from the speech processor and sends them to the receiver/internal processor placed under the skin. The transmitter is held in place on the head by a magnet.
- Receiver/internal processor: Receives the signal from the transmitter and sends it to the electrode array carefully placed inside the cochlea by your surgeon.
- The auditory nerve gets stimulated by the electrode array and the signal is sent to the brain.
- The brain interprets these signals as specific sounds to create meaning.
What Early Progress Looks Like
Now that you know the parts of a cochlear implant, you can see how the system converts acoustic sound into a digital signal and bypasses the damaged parts of the inner ear, allowing the brain to interpret these signals as sound. However, it takes time for the brain to recognize these digital signals as sounds you are used to hearing.
This is why so many users say initial sounds from the implant sound robotic or metallic.
It is important to recognize that part of your cochlear implant journey will include this adjustment to sound. Not only is the brain adjustment to these digital sounds, but it is also receiving signals of sounds the brain hasn’t had to interpret for some time. When you have a hearing loss, depending on the type, your brain loses the clarity of some sounds as hearing loss prevents them from being adequately sent to the brain. If you are deaf or have profound hearing loss, your brain has not received access to any parts of these sounds.
This is where auditory practice steps in.
Your brain has the remarkable ability to learn, all throughout your lifetime. The brain learns through principles of neuroplasticity. Targeted auditory practice takes advantage of how the brain learns so that these digital signals can be better understood by the brain, helping you get better clarity of sound from your cochlear implant and overall satisfaction.
There’s a pretty good article about neuroplasticity here: About Neuroplasticity
The most important parts of neuroplasticity I like to highlight with my clients are: specificity, intensity, and repetition.
Specificity: refers to the practice being specific to what skill you want to gain. For example, if you want to get better at running, you will need to start running.
Intensity: refers to the practice being done with enough intensity (time allotted to the task or level of difficulty) to make change.
Repetition: refers to the practice being completed several times. Consistency matters!
How to Practice
Many of my CI clients ask me for help doing auditory training. First question you need to ask yourself is: are you going to be practicing alone or with someone else? If you have a willing family member or friend to practice with, the possibilities are endless! For instance, you can give your family member or friend a list of words or sentence and try to identify those sentences. If you are practicing alone, you likely will have to lean on technology to help you practice. There are several apps and websites now that are geared towards auditory training. Many companies have even created their own auditory training programs for their CI users.
If you have Med El, there’s a program called ReDi (app on iPhone and Android) more info here
If you have Advanced Bionics, there’s a website called Sound Success more info here
If you have Cochlear America, there’s a program called Cochlear Copilot more info here
There’s also other options like listening to podcasts/audiobooks, or even passively listening to the TV. When working with my clients, I prefer that they do some sort of structured listening activity and not only passive listening to challenge the brain. Many times as well, listening to the TV or a podcast is too advanced for most listeners after activation, which only leads to frustration.
During my time working with clients I recognized that all these programs fall short in some sort of way, whether it be the user interface, the activities themselves, or the confusion on where to begin in the program. I created my own auditory training programs in response to this.
You can find more information regarding this program here: https://www.auditoryally.com/
A Few Things to Keep in Mind
- No two CI journeys look the same
- Progress can be slow at first — and that’s okay
- Small steps done daily lead to big changes
- You are not alone in this journey
The Auditory Ally Blog 