There are clear and well-established links between those identified and fitted with amplification early and good spoken language outcomes, but how much does the time an appropriately fitted hearing instrument is used each day contribute to this? During the first year a device is fitted, the family may struggle to establish consistent hearing instrument usage, especially with pre-schoolers. Barriers to consistent CI use vary with age from young infants with limited head control to pre-schoolers with increased levels of physical activity. A team from North Carolina investigated the link between how much a cochlear implant (CI) is worn and language development in the first year of CI use in the under-five population. They carried out regression analysis between receptive and expressive language outcomes with datalogging from the speech processor. Their findings highlight that there was a positive association between the amount of time the CI is used and good receptive language, but this correlation was not found with expressive language. The lack of association between expressive language and datalogging may be due to the timescale used, as one year of implant use may not be an adequate amount of time to capture the development of expressive language. Careful counselling of families can pose a challenge at a time when they are adjusting to their child having a CI. Clinicians must support families to establish routines and practices where the CI is worn during ‘all waking hours’ to ensure children have the opportunity meet their full language potential.