The aim of the study was to explore patterns of communication between 22 children with cochlear implants (CI) and their parents, teachers and peers in natural interactions over a 2-year period. The children,between 2 and 5 years old when implanted, had used the implant between 1 and 3.5 years at the end of the study. Analyses of videorecorded interactions showed that meaningful oral communication was more easily obtained in the home setting than in the preschool setting.Patterns of communication between parent–child, content and complexity of dialogues, quality of peer interactions, communicative styles of adults, and the use of sign language in communication turned out to be important factors when explaining the result of the CI on the individual child’s development.The children with the best oral skills were also good signers.