The past 20 years have seen the cochlear implant evolve from an innovative but radical concept to the standard of care in the management of children with severe to profound hearing loss. All children receiving the cochlear implant achieve substantial benefit; however, performance gains are optimized by a team approach to the evaluation and management of these children. The critical elements of this team include audiologists, speech pathologists, and surgeons with specific interest, expertise, and dedication to the management of children with cochlear implants. Children are not well served by practitioners who delegate follow-up to educational programs not experienced in children with implants. Long-term involvement and dedication on the part of teachers, speech pathologists, audiologists, surgeons, and family are critical to maximizing the benefit the child receives.