OBJECTIVE The study aimed to assess the auditory skills in multi-handicapped children with cochlear implants. METHODS The study assessed 34 children, who were implanted due to the bilateral profound sensorineural hearing loss. Apart from the hearing loss, all of the subjects suffered from additional impairments (mild motor disabilities, cerebral palsy, cognitive disability, specific learning disability, behavioral disorders, sight impairment), 29 (85.29%) from more than one. Cochlear implantation took place in the Department of Otolaryngology at the Medical University of Warsaw in Poland. The age at implantation ranged from 1.3 to 7.5 years old (mean 3.2 years, SD 1.64). The retrospective review of medical charts, audiology and speech pathology records was based on Champions profile with evaluation at 6, 12, 18-24 months, and 3 years after implantation. When a patient had been referred for developmental evaluation by psychologist, this source of information was also used. RESULTS All of the subjects suffered from additional impairments, and most of them presented more than one additional disability. Individually and as a group, these patients respond well to cochlear implantation. The study population showed improvement in communication code in 31 patients (91.18%), and no improvement in 3 patients (two of them had 6 months follow up and one 12 months follow-up). Also progress in auditory skills was noted in the study population, which was measured as the awareness in environmental sounds--Categories of Auditory Performance (CAP). CONCLUSIONS Multi-handicapped children receive benefit from cochlear implantation. The rate of this improvement is slow but offers better quality of life due to better auditory-communication skills, better self-independence and social integration. The results of implantation in presented group of patients is encouraging.