ObjectiveComparison of preverbal communication behavior in young children before receiving cochlear implants with outcomes 3 yr after implantation on speech identification and speech production tasks, to assess whether outcomes can be predicted from characteristics inherent to the child before implantation.DesignVideo recordings of preverbal communicative behavior were examined before use of the implant to quantify turn-taking and demonstration of autonomy by the child. Speech identification ability was measured 3 yr after implantation based on the Iowa Closed-Set Speech Perception Sentence Test, continuous discourse tracking, and an observational measure of telephone use. Speech production ability was measured 3 yr after implantation by the Edinburgh Articulation Test. Associations between the preimplant measures and the 3-yr outcomes were assessed by correlation analysis of data from 33 children.ResultsThe 3-yr performance measures of speech identification were correlated with the preimplant measure of autonomy. Telephone use and speech production ability were not significantly associated with the preimplant measures.ConclusionsUp to a fourth of the variance in speech identification performance 3 yr after cochlear implantation of young children may be predicted from characteristics that are inherent to the child before implantation. Those characteristics are represented by the demonstration of autonomy in preverbal communicative interactions, whether by means of vocalization or by gesture. If those characteristics are acquired during infancy, outcomes in children with auditory prostheses including cochlear implants may be enhanced by activities that encourage autonomy in early years.