This article reports a longitudinal study of the communicative and linguistic development of five infants, identified as having severe or profound bilateral sensorineural hearing loss, and using amplification consistently, by 3-6 months of age. Each hearing impaired infant was carefully matched for chronological age, social and cultural background with a normally hearing infant. The parents of each of the infants had normal hearing and spoken English was the first language of the home. Video recorded social interaction took place over a variety of semi-structured contexts and occurred at six-weekly intervals from 6 to 21 months. The pattern of gestural and vocal communication and the transition to symbolic language by each hearing impaired and hearing infant forms the focus of this report. It is concluded that severely and profoundly hearing impaired infants can follow a normal pattern of communicative and linguistic development (albeit sometimes delayed) when hearing impairment is identified within the first months of life and appropriate interventions are in place.