A few days ago, a good friend complained that she didn’t know how to cook. I responded by telling her "If you can make a salad, you can also make soup. I'll send you the recipe."

The exchange made me think of my experiences with patients who are adult CI recipients.

Part of my job as a therapist is to help patients acquire new auditory and communication skills. Just as important is assisting adults to utilize those skills and apply them to diverse situations in life to maximize their ability to negotiate the world. After someone has acquired a particular auditory skill, I try to guide them to use their new abilities in other ways and in different situations that they previously thought were beyond their capability or may have been afraid to try.

People who are not receiving formal auditory learning services (with a professional expert in auditory skill development) should consciously focus on expanding their auditory abilities and utilizing them in various daily life situations.  For example:

If you can hold a simple conversation in a quiet room with a familiar person without lip-reading (speechreading), you may be able to:

• Talk on the phone under certain conditions
• Understand two people with clear speech talking to each other close to you—even if you are not part of this conversation. (Also called “overhearing.”)
• Understand the voice instructions of your car navigator
• Converse with the person sitting next to you in the car (at least some of the time)
• Hold a conversation while being occupied in another (not noisy) activity 
• Understand voice messages sent to you by people you know well (You can slow down the speaking pace of the recording to help)
• Respond to simple questions while you were not being attentive to the speaker, provided the speaker is close enough to you and there is minimal noise in the room. If that is not yet possible, try practice this task intentionally

What might help you develop the skills to successfully master more challenging listening situations?

• Understand the conditions that affect your ability to understand speech. Learn to recognize the effects of less than ideal listening situations on speech perception of variables such as noise (some types of noise are more disturbing than others), distance from the speaker, fatigue (yours), speaker's speech intelligibility, familiarity with speaker, and prior knowledge of the conversation content. 
• Planning your practice. Consider the variables that  may affect your speech comprehension and build a graded training program in increases difficulty over time.
• Share your challenges and goals with the partners who will help you practice. 
• Don’t be afraid to make mistakes. Skill-building is often accompanied by insecurity and fear of failure. Choose people you feel comfortable with to try out challenging situations and encourage them to give you real-time feedback. This will help you learn and gain confidence in your abilities.
• Use streaming technology available with your sound processor (or assistive listening devices or ALDs) when conversing in the car, talking on the phone, watching TV, participating in video conversations, and other situations.
• Intentionally change old listening habits. People who have experienced long periods of hearing loss may restrict their attentiveness and limit listening to specific (comfortable) situations. They may simply ignore speech that is not directed to them, not listen when they are missing words, and avoid social activities. These listening habits may hold back progress and benefits of the CI. Putting yourself in more varied hearing situations and communication settings will provide you with opportunities to find solutions to challenges and acquire more advanced listing skills.
• Have high expectations. Believe that improvement is possible. Know that hearing has many uses, and the main challenge is to implement your hearing abilities in as many situations as possible. Pursuing your goals and meeting them will strengthen your belief in the cochlear implant technology and in yourself.

Good luck!