This paper assesses the expressive spoken grammar skills of young deaf children using cochlear implants who are beginning formal education, compares it with that achieved by normally hearing children and considers possible implications for educational management. Spoken language grammar was assessed, three years after implantation, in 45 children with profound deafness who were implanted between ten and 36 months of age (mean age = 27 months), using the South Tyneside Assessment of Syntactic Structures (Armstrong and Ainley, 1983) which is based on the Language Assessment and Remediation Screening Procedure (Crystal et al., 1976). Of the children in this study aged between four and six years, 58 per cent (26) were at or above the expressive spoken language grammatical level of normally hearing three year olds after three years of consistent cochlear implant use: however, 42 per cent (19) had skills below this level. Aetiology of deafness, age at implantation, educational placement, mode of communication and presence of additional disorders did not have a statistically significant effect (accepted at p less than or equal to 0.05) on the development of expressive spoken grammar skills. While just over half of the group had acquired spoken language grammar skills equivalent to or above those of a normally hearing three year old, there remains a sizeable group who, after three years of cochlear implant use, had not attained this level. Spoken language grammar therefore remains an area of delay for many of the children in this group. All the children were attending school with hearing children whose language skills are likely to be in the normal range for four to six year olds. We therefore need to ensure that the ongoing educational management of these deaf children with implants addresses their spoken grammar delay in order that they can benefit more fully from formal education. (Contains 7 figures and 2 tables.)