Exposure to high quantity and quality of language in the neonatal period is critical to neurocognitive development; however, Neonatal Intensive Care Unit (NICU) environments may contribute to language deprivation. Using qualitative thematic content analysis, this study aimed to characterize the knowledge and attitudes of NICU staff and patient families toward the importance of early language experience, the current NICU language environment, and the benefits and barriers of communication in the NICU. Results revealed that all respondents recognized the importance of communication for optimal cognitive development, though few understood why. Staff and family members alike recognized the role of nurses as coaches and role models in promoting communication at the bedside. Nurses generally felt that family members communicate less with their babies than family members themselves perceived, and that cell phone use has fewer communicative advantages than parents perceive. Respondents reported that patient illness, lack of time, and intimidating equipment all raise barriers to communication. These findings yield important considerations for developing educational interventions to improve NICU language environments, including a synergistic, dual focus on both staff and families. Communication in the NICU is a low cost, feasible, and accessible target with aims of ensuring optimal neurocognitive development for at-risk children.