Beginning to talk at 20 months: early vocal development in a young cochlear implant recipient.

Early vocal development, consonant production, and spoken vocabulary were examined in a deaf toddler whose multichannel cochlear implant was activated at 20 months. Parent-child interactions were recorded before implantation and at monthly intervals during the first year of implant use. The child's utterances were classified according to developmental levels from the Stark Assessment of Early Vocal Development. The emergence of consonant types and consonant features were documented through listener transcription. Parent reports were used to monitor oral vocabulary growth. A large increase in canonical and postcanonical utterances was observed after 5 months of implant use, and these advanced prelinguistic forms were dominant in all subsequent recording sessions. Increases in the diversity of consonant types and features suggested that auditory information was used to increase phonetic diversity. It was reported that the child understood almost 240 words and spoke approximately 90 words after one year of implant experience. The combination of cochlear implantation at a young age, family support, and regular intervention appeared to facilitate efficient early vocal development and gains in spoken vocabulary.