According to several adults, sound with a cochlear implant is different than that heard with a hearing aid or with a normal ear. For some people, sounds may seem metallic, muffled or sharp, and for others, it comes close to the actual sound. The appreciation of sounds will evolve over time. At the beginning of the programming, some people may find sound to be unpleasant, but will get used to it afterwards. Children with a significant degree of deafness since birth have nothing to compare the sounds they are hearing with, as they only experienced limited benefits provided by hearing aids. It will be for them their way of hearing.