Cochlear Implantation (CI) is now the standard of care for rehabilitation of children with bilateral severe to profound sensorineural hearing loss. It improves the children’s linguistic input and helps them to develop language. The literature published so far has shown a wide variability in language outcomes of children with CIs. The objective of this study was to define predictors of vocabulary in children implanted between six and 10 months of age. The authors recruited children with severe to profound sensorineural hearing loss and without any other disabilities, prior to their implantation. Using subscales from Bayley Scales III, they assessed the development of the children. Following CI surgery, the children’s use of gestures and vocabulary was evaluated periodically. Pre-implant receptive communication, early gesture use, fine motor and cognitive skills were found to be significant predictors for development of vocabulary one year after implantation. The authors conclude that a non-verbal means of expression pre-implant can help develop post-implant vocabulary. They suggest that strategies to develop the fine motor skills in infants with CI and encouraging their use of gestures pre-implant to communicate may help in developing early vocabulary post-implantation.