Cochlear Implant Rehabilitation for Adults
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Listening to the Sounds Around You

Posted By Naama Tsach, PhD, Tuesday, February 23, 2016
Updated: Monday, February 22, 2016

Today we will discuss the issue of environmental sounds. Typically, this topic receives less attention compared to speech perception. However, for many CI recipients the perception of environmental sounds is very significant and has a unique positive contribution to their quality of life.

According to CI user' reports, the ability to perceive environmental sounds helps them to feel connected to their environment. For example, these sounds help them to know whether they are home alone, whether someone is taking a shower or washing dishes, whether someone is knocking on the door or ringing the doorbell. The perception of environmental sounds contributes to one's sense of orientation and confidence.  As one of my patients once said, "I use my CI regardless of I am home alone or with others; I even use it when I go out to work in my garden by myself." The benefits provided by cochlear implants are not restricted to communication with others.

Immediately after the implant is switched-on, you are exposed to a world of sounds. The gate opens and a range of auditory stimuli flow in.  You hear others’ speech as well as the sounds of animals, nature, music, appliances, cars, and much more.  Access to all of this information can make you very happy; it can also be irritating or even overwhelming.

At first, new CI recipients may experience this blend of sounds as unwanted noise that mainly interferes with understanding speech. This aspect of hearing with a CI is very personal and is affected by a range of fact of factors that make up your pre-implant experience such as duration of deafness, amount of residual hearing, and hearing aid utilization.   

If you had a significant hearing experience prior to receiving a CI, you may be very happy that these sounds have become accessible to you again. However, it will take time to get used to the quality of these environmental sounds. During the initial states of implant usage, you may feel a bit disappointed.  The sounds may not be what you remember them to be.  Sounds may seem to be different, less pleasant, and less clear. After a period of time, the way you perceive sounds will improve and you likely will learn to understand and enjoy the richness of your new world of sounds.

If you did not have a significant hearing experience prior to implantation, these sounds may be initially meaningless and even distracting. Over time the fog will clear and environmental sounds will become increasingly meaningful and useful.

Tips for Improving Environmental Sound Perception 

·      Share your experiences with your audiologist.  Are there any specific sounds that bother you or make you feel uncomfortable? You may find it useful to keep a journal of your daily experiences. Your audiologist may adjust your map based upon your experiences, or provide direction on use of noise reduction strategies in your processor, or encourage you to relax and hopefully gradually adapt to listen to these sounds.

·      Understanding environmental sounds takes time and practice. As you become a more experienced CI user, you will reap more benefits from your access to environmental sounds. You will recognize them and enjoy listening to the sounds around you. 

·      When you notice a sound you do not recognize, ask a family member or friend to identify it for you.  This process will improve your listening skills as well as your auditory orientation.

·      Work intentionally and actively on your environmental sounds perception skills. Try concentrating on a different sound each time. In order to practice perception of a sound, it is helpful to listen in a quiet space free of distracting sounds. When you are at the beach, you can practice listening to the sounds of the waves; in the parking lot you can practice listening to the sound of your car door locking; at home, you can listen to the sound of running water and compare it to the sound of dripping water; you can listen to the sounds generated by different kitchen appliances.

·      Learn which sounds are typical of specific environments to aid you in the identification process. Which sounds do you hear? Which sounds are more important for you to listen to? What are the sounds that are more pleasant for you to hear? Which sounds are less pleasant? Improving your awareness of the sounds in specific environments will help you to identify them.

·      Recognition of environmental sounds will help you to determine which environmental sounds interfere with speech perception. Accordingly, you may use that information to help plan your conversation settings.

Although the benefits of cochlear implants do not typically include perception and understanding of environmental sounds, you shouldn't underestimate the importance of these hearing skills. Your auditory learning includes this aspect of hearing; learn to appreciate it and derive the full benefit and satisfaction of your listening achievements.


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The mission of the American Cochlear Implant (ACI) Alliance is to advance access to the gift of hearing provided by cochlear implantation through research, advocacy and awareness.