Most impossible goals can be met simply by breaking them down into bite-size chunks, writing them down, believing them, and going full speed ahead as if they were routine.
Don Lancaster

Although he is best known as an inventor and microcomputer engineer, this wonderful excerpt by Don Lancaster is so relevant to auditory skill development for CI recipients.

Many cochlear implant recipients note a gap between their ability to understand speech while practicing auditory training at home and their ability to understand speech in real life. Why is that? 

There are a number of possible reasons why this is the case. People typically conduct their auditory training:

• While in favorable acoustic conditions (i.e., a quiet room and/or using streaming technology or assistive listening devices (ALDs)
  
  
• Listening to a single speaker
  
  
• Practicing speech understanding with speakers who have highly intelligible speech (i.e., professional narrators for audiobooks)
  
  
• Using structured materials designed specifically for auditory training
  
  
• Listening to speakers at a relatively slow speech pace
  
  
• At a time when they are totally focused on listening, which is not characteristic of everyday life circumstances

Such auditory skill development is primarily helpful in specific listening situations such as having conversations in a quiet room with one person or familiar people, interacting with people who speak very clearly, participating in discussions on known or expected topics about which the person has prior knowledge, and in favorable acoustic and communication environments.

Communication in Daily Life is Complicated 

These auditory skills might not be sufficient when conversing with people who are either less familiar to the listener, have less intelligible speech, or both.  Auditory skill development may not be as useful when a CI recipient is moving about in a room, or when conversations are held in noisy places. Another challenging situation is when two people converse in the presence of other people with the expectation that everyone has been able to join the conversation and has heard and understood what has already been said.

How do you transition from understanding speech in favorable conditions to understanding speech in life?

• Challenge yourself to understand more than one sentence at a time without visual clues. Gradually listen to several sentences without speechreading.
  
  
• Practice having a conversation with a familiar person when you are simultaneously involved in another activity like painting or folding laundry. Don’t make this overly difficult by practicing conversations while occupied with noisy activities (i.e., washing dishes or listening to music) since it may be too difficult, even for people with typical hearing. 

• When you are in a quiet room listening to videos or other auditory content on your computer or telephone, try the following:
  • Practice without streaming the materials directly to your speech processor
  • Sit six feet away from the sound source
  • Walk around the room while listening.  This is more challenging than listening and understanding speech while sitting in one place. This will help you gain experience in processing sound coming from different directions and at different intensities.
    
    
• Practice your understanding of voicemail messages. Ask friends and family members to send you short voice messages on your phone. If needed, slow the pace of such messages to help with understanding.  Apple has directions on how to do that on their phones.

Make Listening More Challenging

• Practice understanding children's speech. People with hearing loss often find it difficult to understand children's speech, which might be too soft or too fast or unclear. You can find many online videos of children talking. Choose videos with no or a minimum of bothersome background noise. You might turn on captions to help you practice understanding children's speech.
  
  
• Expand the circle of people you talk with on the phone, especially those who are less (or not) familiar to you.
  
  
• Practice understanding speech in real world background noise. Listen to speeches given by famous people. You can find videos of speeches from demonstrations or other events that often have background noise. Download captions ahead of time to support your understanding and use as necessary. 
  
  
• Try to understand lyrics in songs. This activity is training for understanding speech in background noise. (You can find lyrics to songs on the Web; view them and then listen without the text in front of you.)
  
  
• Learn to effectively use Assistive Listening Devices (sometimes called ALDs) and the special programs for listening in noisy situations available on your sound processor. 
  
  
• Practice listening to a conversation with multiple speakers, rather than listening to just one person. You can also use recorded interviews and dialogues. Listening to two people talking to each other is more challenging than listening to contents presented by one person. 
  
  
• Ask friends or family members to record themselves talking to each other and send the recording to you. It may be quite challenging, so ask them to speak relatively slowly and provide you with the topic of their conversation. 
  
  
• Learn how to use speech-to-text technologies to help you participate in more social activities.
  
  
• Try to be attentive and listen (almost) all the time!
  
  
• Try to understand public announcements 
  
  
• Practice your hearing ability even if you are not part of the conversation. Listen and try to understand discussions held near to you.  
  
  
• Eavesdrop and try to understand what people next to you are talking about on their phone.

Initially many of these activities are likely to be difficult and tiring. Over time they will become more natural, and you may even understand speech unintentionally and without extraordinary effort.

It takes time and practice, but setting high goals is always the first step!

Good luck.