OBJECTIVE To evaluate the auditory and speech outcome in deaf children with deaf parents (CDP) after cochlear implantation (CI), emphasizing both the presence of additional caregiver and patients' main communication mode. METHODS Retrospective case review. METHODS Cochlear implant center at a tertiary referral hospital. METHODS Fourteen CDP and 14 age- and sex-matched deaf children with normal-hearing parents (CNH). METHODS The Korean version of Ling's stage (K-Ling) and Category of Auditory Perception (CAP) were administered to the children to assess the speech production and auditory perception abilities, preoperatively and 3, 6, 12, and 24 months after CI. To elucidate the effects of the additional caregiver and main communication mode of the implanted child, the patients were divided into the following groups: with additional caregiver(s) who have normal hearing (n = 11) versus without additional caregiver (n = 3); sign language plus oral communication (S+O) group (n = 9) versus oral communication only (O) group (n = 5). RESULTS CAP scores and K-Ling stages improved remarkably in both CDP and CNH, and no significant differences were found between the 2 groups. Within the CDP group, CAP scores and K-Ling stages improved significantly in CDP with an additional caregiver than those without. Auditory perception and speech production performances in the S+O group were similar to those in the O group. CONCLUSIONS CDP can develop similarly to CNH in auditory perception and speech production, if an additional caregiver with normal hearing provides sufficient support and speech input. In addition, using sign language in addition to oral language might not be harmful, and these children can be a communication bridge between their deaf parents and society.