The purpose of this longitudinal case study was to closely examine one deaf child's experience with a cochlear implant and his speech, language, and communication skills from kindergarten through middle and high school using both developmental and sociocultural frameworks. The target child was one of the first children to receive a cochlear implant in the United States in 1988, when he was 5 years of age. The developmental analysis revealed that prior to receiving a cochlear implant the child demonstrated profound delays in speech and language skill development. His speech and language skills grew slowly during the first 3-4 years following implantation, very rapidly from about 5 through 7 years postimplantation, then slowed to rates that were highly similar to same-age peers with normal hearing. The sociocultural analysis revealed that the child's communicative competence improved; that he used sign language but use of sign language decreased as his oral communication skills improved; that as his oral communication skills improved, the adults talked and directed the topic of conversation less frequently; and that topics became less concrete and more personal over time. The results of this study indicate that we may learn more about how to support children who use cochlear implants by examining what they are saying as well as how they are saying it.