Results: the main areas which were modified based on participatory feedback were the variety of immersive scenarios to cover a range of ages and interests, the number of levels of complexity to ensure small improvements were measured, the feedback and reward schemes to ensure positive reinforcement, and specific provision for participants with balance issues, who had difficulties when using head-mounted displays. The effectiveness of the finalised BEARS suite will be evaluated in a large-scale clinical trial. We have added in additional login options for other members of the family and based on patient feedback we have improved the accompanying reward schemes. Conclusions: Through participatory design we have developed a training package (BEARS) for young people with bilateral cochlear implants. The training games are appropriate for use by the study population and ultimately should lead to patients taking control of their own management and reducing the reliance upon outpatient-based rehabilitation programmes. Virtual reality training provides a more relevant and engaging approach to rehabilitation for young people.