One of the most exciting dates in your hearing journey will probably be the cochlear implant switch-on date: the date when the hearing implant – the Active Middle Ear Implant or Active Transcutaneous Bone Conduction Implant and its external audio processor – is turned on (activated) for the first time. Sometimes, it’s called the “switch-on day”, “activation” or “first mapping.” Depending on where you live, and the specific type of surgery you have had, the switch-on will probably take place between three to six weeks after your surgery. It is important that the wound has fully healed before activation. However switch-on is only the first step. The audio processor then has to be programmed according to your hearing ability and daily needs.


  • On switch-on day, your audiologist will visually inspect your wound to ensure that it has healed fully.
  • The audiologist will check the magnet strength of the audio processor to ensure that it is properly attached and is communicating with the implant.
  • The cochlear implant processor will be connected to the audiologist’s computer for MAPping. Mapping (or MAPping) is the term for programming a cochlear implant to the specifications and needs of its user. MAPs are programs that help to optimise the cochlear implant user’s access to sound by adjusting the input to the electrodes on the array that is implanted into the cochlea.
  • The audiologist will activate the audio processor to send signals to the electrodes in your cochlea for the first time.
  • Using a series of “beeps,” and measuring your responses, the audiologist will set levels for each electrode.  The audiologist will use this information to create a program, or “MAP”, that will be customised especially for you.
  •  At the end of the fitting, all these settings will be saved to the audio processor so that you can take it home and start listening in different environments and different listening situations.
  • Once the programming has been completed, you will be shown how your SAMBA audio processor works and how to manage it. You will be given a SAMBA remote control which makes the audio processor really easy to handle


  • Following the switch-on, you will return to the audiologist regularly – at least once a week  for the next three to six weeks, depending on your age and hearing level. In some instances it may only be necessary to have your first follow-up visit up to four weeks post implant, giving you time to become accustomed to your new hearing capability.
  • During follow-up visits, the audiologist will fine-tune the settings of the processor to fit your hearing preferences.
  • The audiologist will also check that the audio processor is in good working condition.
  • The skin over the implant will be checked to ensure that the magnet strength is correct and that any adjustments required are made.
  • Programming and mapping will continue at different intervals for the rest of your life.
  • Troubleshooting will also take place on an ongoing basis to attend to any problems with the device. CHi may provide you with loan equipment when required.
  • The audiologist will also keep you up to date with any new developments and technology in the field of cochlear implants.

After activation of your device, it is vitally important that you follow up with a rehabilitation programme so you can adapt to hearing through the cochlear implant. Rehabilitation is essential to make the most of the cochlear implant.

Speech and language rehabilitation

Following implantation and switch-on, you will see a speech and language therapist for auditory-verbal therapy. Auditory-verbal therapy is essential for everyone who has received an implantable device. It does not matter whether they are still pre-lingual (i.e. a child who has not yet developed the ability to speak due to their hearing loss) or post-lingual (i.e. someone who has already learned to speak, but whose verbal communication skills are impaired by their hearing loss).

Auditory-verbal therapy is a specialised type of therapy designed to teach you to get the most from your implant. You will have to learn how to use the hearing provided by the implant for understanding spoken language and learn to communicate.

If the patient is your child, the speech-language therapist will also work with you during auditory-verbal therapy sessions and teach you how to emphasize residual hearing as well as how to interact with your child using an auditory-verbal approach.

If you are an adult, significant people in your life will also be involved in your auditory verbal therapy sessions to optimise the outcomes achieved.

Over time, the speech-language therapist will teach you to develop hearing as an active sense, so that listening becomes more automatic and you seek out sounds in life. Through therapy, hearing and listening will become an integral part of communication, recreation, socialisation, education and work.