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Cochlear implants are uncontroversially helpful in restoring hearing to native spoken language users with later or progressive hearing loss. This chapter focuses on the more difficult issues in the cochlear implantation of children born deaf or with significant loss of hearing before fully acquiring their first language. It emphasizes the language fluency in young deaf and hard of hearing children and makes suggestions for the various professionals who work with children who receive cochlear implants and their families to foster linguistic competence. The chapter also emphasizes that "language fluency" is independent of modality, and thus includes both signed and spoken language. While deaf children differ and no one strategy works for all deaf children, the inclusion of rich sign language exposure is far more likely to help than to hurt. Medical professionals point to the rapid development of the brain and argue that earlier implantation is better in order to increase the likelihood that a child can receive auditory benefit.
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