Background Pragmatics is the social use of language that draws on understanding human interactions in specific contexts and requires engagement with a communicative partner or partners. The hearing-impaired children are known to have a pragmatic language delay as hearing impairment deprived of exposure to natural communication interactions, in addition to the language delay they have. Since the age of implantation has emerged as an important predictor of language, hearing, and speech in children who use cochlear implants (CI), question aroused about the benefits of early cochlear implantation on pragmatic language development in those children. Thus, this study aims to compare the pragmatic language development of the prelingual hearing impaired children who cochlear implanted before the age of 3 years and those who cochlear implanted after the age of 3 years. Results The two study groups showed no significant differences regard their scores in the Egyptian Arabic Pragmatic Language Test (EAPLT). The two studied groups had pragmatic language scores below their 5th percentile. Among the studied groups, the scores of the EAPLT were positively correlated to the age of the children, the children’s language abilities, and the duration of the received language rehabilitation, with no significant correlation to the age of implantation. Conclusions The age of implantation has no impact on pragmatic language development in children with CI. The prelingual children with CI are susceptible to delays in the pragmatic language development that is primarily related to the age of those children and their language abilities, besides their experience in social interactions. These results should be considered in their rehabilitative plan and advocate the importance of early incorporation of pragmatic behaviors into their intervention programs.

Background Hearing impaired children have delayed development of pragmatic skills as hearing impairment (HI) deprives them from exposure to natural communication interactions. The rehabilitation of children with HI aims to improve their listening skills for better language development and better communication and social interactions. Aim of this work to compare the pragmatic language development of the prelingual hearing impaired children who were cochlearly implanted before the age of 3 years and those who were cochlearly implanted after the age of 3 years. Methods Sixty Egyptian Arabic-speaking children with prelingual severe to profound sensory neural hearing loss, thirty children who were cochlearly implanted before the age of 3.0 years compared to thirty children who were cochlearly implanted after the age of 3.0 years. Language assessment was done by Modified Preschool Language Scale – 4th edition (PLS–4), the Arabic version and pragmatic development was assessed by Standardized Egyptian Arabic Pragmatic Language Test (EAPLT). Results The two study groups showed no significant differences regarding the receptive, expressive, and total language test scores by PLS-4. Group I showed a significant difference (improvement) regarding the pragmatic factors while there were no significant differences between the two study groups regarding the rest of the pragmatics scores by EAPLT. Conclusion The pragmatic language of cochlearly implanted children either who have been implanted before or after 3 years old is affected. This higher susceptibility to pragmatic impairment in prelingual cochlearly implanted children, as well as the importance of pragmatic skills for further social-communicative and academic careers, should be considered in their rehabilitative plan and advocate the importance for early incorporation of pragmatic behaviors into their intervention programs.