Cochlear implant is a treatment for some children with profound sensorineural hearing loss. The cochlear implant consists of two parts — one is surgically implanted, the other is externally worn.

Surgery to implant the device is just one step of the cochlear implant process. Detailed post-operative care continues for a year or more after surgery and can help determine how much hearing and speech improvement your child will achieve. Outcomes can vary, however, based on the individual.

Below are general guidelines for follow-up care after cochlear implant surgery at The Children’s Hospital of Philadelphia (CHOP). How often your child is assessed — and what additional services he may need — may vary depending on his particular condition or needs.

Initial cochlear implant activation

About two to three weeks after your child’s cochlear implant surgery, your child will return to the Hospital. An audiologist will activate your child’s implant.

Often, children are not able to understand speech through the speech processor on the first day. Some children, who have not had a meaningful connection with sound prior to cochlear implant activation, may not show consistent responses to sound at this initial activation. This is typical and does not necessarily indicate future performance. Still, initial activation is an exciting day and marks the beginning of a new chapter for children and their families.

An audiologist will also review the cochlear implant equipment and accessories with your child and family at this appointment.

One week after implant activation 

One week after your child’s cochlear implant is activated, your child will again meet with an audiologist. The audiologist will perform behavioral testing on your child to determine how she is responding to sound.

Following behavioral testing, the cochlear implant program — or what we call the plan of care created at the time of your child’s initial activation — will be refined. Your child, who will have one week of experience with the cochlear implant, will hopefully be able to provide more consistent responses to sound from the cochlear implant.

One month after activation

One month after your child’s implant is activated, he will be assessed by an audiologist and a speech-language pathologist.

The audiologist will measure your child’s responses to sound and further fine-tune the cochlear implant to optimize your child’s access to sound. As your child gets used to the cochlear implant, his responses to sound — and understanding of speech — should improve. At each visit, your child’s audiologist can explain what you should realistically expect regarding your child’s performance with the cochlear implant.

This appointment will include your child’s first assessment by a speech-language pathologist (SLP) following implant activation. The SLP will assess your child’s ability to make speech sounds, syllables and words.

Two months after cochlear implant activation

Two months after your child’s implant is activated, she will be assessed by an audiologist. Your family will also meet with a child and family therapist.

The audiologist will again measure your child’s responses to sound and further fine-tune the cochlear implant. These appointments are critical to ensure your child’s access to sound is optimized.

Your family will also meet with a child and family therapist at CHOP, who will support each of you during the cochlear implant fine-tuning process. You should meet with the same therapist you worked with before your child’s cochlear implant surgery.

This is typically the last automatically scheduled appointment with the CHOP child and family therapist.  If behavioral or emotional concerns or questions arise in the future regarding your child’s use of the cochlear implant, please contact Rebecca Witmer, LCSW.

Three months after implant activation

Three months after your child’s implant is activated, he will again be assessed by an audiologist and a speech-language pathologist.

The audiologist will measure your child’s responses to sound with the cochlear implant. The implant will be further fine-tuned to optimize your child’s access to sound. As your child gets more used to the implant, his responses to sound and understanding of speech should improve.

The SLP will assess your child’s ability to make speech sounds, syllables and words.

Six months and nine months after activation

At six months and nine months post implant activation, your child will again be assessed by an audiologist and a speech-language pathologist.

One year after implant activation

At this point, your child has used the cochlear implant or implants for one year. The audiologist and SLP will complete a formal assessment of your child to determine how much her listening skills and communication development have changed over the past year.

Long-term follow-up care 

After the first year post-cochlear implantation, assessment appointments become less frequent. Most children return for continued monitoring two to three times in the second year post-surgery, then every six months in the third year and beyond.

Once your child is an established long-term user of the cochlear implant, he may return every six to 12 months for continued performance evaluations and speech processor programming.

Depending on your child’s progress with the cochlear implant, the general guidelines for appointments listed here may be adjusted to meet your child’s needs.