Mastery of any natural language, signed or spoken, is expected to support healthy cognitive and psychosocial development, thereby promoting school readiness and long-term success. We must not forget that even in the group of best-performing children in this study, 49% fell below the average range on language proficiency; in hearing children, this figure would be a mere 16%. Clearly, much more work remains to be done to maximize deaf children's developmental potential.

Differential auditory experiences of children with hearing-loss who receive cochlear implants (CIs) may influence the integration of lexical and conceptual information. Here we measured eventrelated potentials during a word-picture priming task in CI-using children (n = 29, mean age = 81 months) and typically-hearing children (n = 19, mean age = 75 months) while they viewed audiovisual-word primes and picture targets that were semantically congruent or incongruent. In both groups, semantic relatedness modulated ERP amplitude 300-500 ms after picture onset, signifying an N400 semantic effect. Critically, the CI-using children's responses to unrelated pairs were significantly more negative than hearing children's responses. Group differences were mirrored in an earlier 150-275 ms time window associated with a P2 response. The present findings suggest attentional and/or strategic differences impact semantic processing and contribute to the N400 differences observed between groups.