Why Your Child May Refuse Their Cochlear Implants: The Role of Overstimulation

If your child refuses to wear their cochlear implant (CI) processors, it might not be a behavioral issue—it could be overstimulation. This is a critical but often overlooked problem in pediatric CI use, and unfortunately, the common advice parents receive is to just "do your best to keep the processors on."

Behavior Is a Form of Communication

Our story began when our son started resisting his CI processors. We were told by professionals to keep them on “no matter what.” But forcing a child to wear something that causes discomfort doesn’t solve the issue—it can amplify the distress. Children often can’t express discomfort with words, especially if they’re young or nonverbal. Their only option is to act out—by crying, removing the headpiece, or withdrawing.

What the Experts Say

Dr. Joan Hewitt, Au.D., a pediatric audiologist, explains:

“Our brains crave hearing. Children should want to have their CIs on. If a child resists putting them on, winces, or doesn’t replace the headpiece when it falls off, it’s possible the CIs are providing too much stimulation.”

A 2011 study by Berger et al., Overstimulation in Children with Cochlear Implants, found that common signs of overstimulation include:

  • Refusal to wear the processor

  • Loud or distorted speech

  • Short attention span and agitation

  • No progress despite consistent therapy

When stimulation levels were reduced, children showed rapid improvement in voice quality and behavior.

Programming Cochlear Implants for Kids Is Different

According to Jennifer Mertes, AuD, CCC-A, and Jill Chinnici, MA, CCC-A (AudiologyOnline, 2006), programming children’s cochlear implants requires specialized training. Kids aren’t just “small adults”—they may not provide reliable feedback during mapping sessions. That’s why pediatric audiologists must rely on:

  • Input from parents, teachers, and therapists

  • Objective measurements (NRT/NRI, ESRT)

  • Behavioral observations and testing

The audiologist’s experience with pediatric CI mapping is crucial.

Our Experience: The Right Audiologist Made All the Difference

After multiple failed attempts to resolve the issue, we sought a second opinion from an audiologist who specializes in pediatrics. She immediately identified that our son’s map was overstimulating. After reprogramming with a more suitable method, he happily wore his processors again—with no resistance.

What You Can Do

If your child consistently refuses to wear their CIs:

  • Look beyond behavior—it may be a symptom, not the cause

  • Consult your audiologist and mention possible overstimulation

  • Seek a second opinion if issues persist

  • Monitor for physical discomfort (e.g., red, irritated skin from magnet strength)

#cochlearimplants #mapping #pediatricaudiology #CIwear #hearinghealth

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