Over the last eight years, Nottingham auditory implant programme have developed and validated a profile of auditory milestones for use with children receiving bilateral cochlear implants under the age of two years. The structure of the Nottingham Auditory Milestones profile (NAMES) comprises of five milestone stages at differing periods of use (three months, six months, 12 months, 24 months and 36 months). Each stage is broken down into 10 key skills which should be achieved within the stage, e.g. child recognises if the system stops working (Skill 1; Milestone 3). The paper details three very different case studies that illustrate how the profile can be used by both parents and professionals. In some circumstances the profile provides reassurance that the child is performing appropriately for their duration of cochlear implant use. However, it can also flag when a child is not performing as expected. NAMES will be a very useful tool within programmes, as currently there is a reliance on concerns being raised using tools designed for typically developing and normally hearing children. Monitoring progress using NAMES ensures a more individualised approach for each patient. Prior to implantation the tool can be used when counselling families. Post-implant, the profile provides a framework for expectations and monitoring of achievements. However, parents and local professionals are always to be encouraged to raise any concerns that they have with the implant team. This allows the team to be proactive and react to any changes in family circumstances or lead to a change of approach. It should be noted that this is a tool to be used alongside, rather than as a substitute for regular contact with implant staff over the initial three years of implant use.