Extensive research has demonstrated the benefits of cochlear implants (CI) in contributing to improve the linguistic skills of children with hearing impairment; however, few studies have focused on the development of pragmatic ability and its relationship with age of implantation. Pragmatics is the ability to use language in different contexts and its development has crucial implications, e.g., social inclusion and professional attainments. In this study, we conducted a comprehensive assessment of pragmatic ability using the Language Pragmatic Abilities (APL Medea), a battery composed by five different tasks: Comprehension of Metaphors, Implicit meaning, Comics, Situations and Colors Game (a perspective taking task). Eighteen children with early CI, belonging to 3 different age groups (6; 11-7; 11, 8; 0-8; 11 and 9; 0-9; 11 years-old), and twenty-four children with typical development (Control Group) participated to the study. We also investigated how the precocity of CI, i.e., age of first implantation, may affect the pragmatic development.Globally, children with CI obtained lower scores in the APL Medea battery than typically hearing children. However, focusing on the Medea tasks separately, children with CIs differed from their hearing peers only in Comics and Colors Game tasks. Finally, age of implantation was a moderate but significant predictor of pragmatic performance.

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Cochlear Implants (CIs) enhance linguistic skills in deaf or hard of hearing children (D/HH). However, the benefits of CIs have not been sufficiently studied, especially with regard to communicative-pragmatics, i.e., the ability to communicate appropriately in a specific context using different expressive means, such as language and extralinguistic or paralinguistic cues. The study aimed to assess the development of communicative-pragmatic ability, through the Assessment Battery for Communication (ABaCo), in school-aged children with CIs, to compare their performance to a group of children with typical auditory development (TA), and to investigate if CI received under the age of 24 months promotes the typical development of such ability. Results show that children with CIs performed significantly worse than TA on the paralinguistic and contextual scales of the ABaCo. Finally, the age of first implantation had a significant role in the development of communicative-pragmatic ability.