OBJECTIVE To determine the viability of giving implants to children <2 years old and to assess the development of speech perception. METHODS A prospective study with a follow-up period of 1-5 years. METHODS New York University Medical Center. METHODS The patients consisted of 11 consecutive profoundly deaf children, aged 14-23 months, who were given the Nucleus cochlear implant. METHODS Closed- and open-set speech perception were assessed preoperatively and postoperatively using the following measures: Early Speech Perception (ESP) test, the Northwestern University children's perception of speech test (NU-CHIPS), the Glendonald auditory screening procedure (GASP) word and sentence tests, the phonetically balanced kindergarten (PBK) word test, common phrases test, the multisyllabic lexical neighborhood test (MLNT), and the lexical neighborhood test (LNT). RESULTS Paired t test was used to examine changes in scores from the preoperative test interval to the last available postoperative assessment. Results indicate that all patients had significant improvement from preoperative performance to the last postoperative evaluation and were using oral language as their means of communication. There were no medical or surgical complications. CONCLUSIONS Children <2 years old receive substantial benefit from a multichannel cochlear implant with no increase in risk when compared with older children.