It is well known that cochlear implants can greatly help the hearing and speech abilities of people with profound hearing loss, and that the ability to communicate, socially process and participate in cooperation with others is significantly improved after cochlear implantation. The factors that influence the outcome of cochlear implantation are complex, but from a rehabilitation perspective, they are mainly influenced by age at implantation and the length of post-operative rehabilitation training. However, some young people with profound hearing loss miss the best time to get a cochlear implant for various reasons, and thus miss the golden time for speech development. This is a very difficult question to answer, and we need to discuss it in terms of historical data and relevant literature. According to the literature “Evaluation of the rehabilitation effect of language comprehension after cochlear implantation in adolescents with prelingual deafness”, 75 cases of adolescents with prelingual hearing impairment who had unilateral cochlear implantation in a hospital in Anhui Province from 2006 to 2012 were divided into two groups, aged 7 to 18, with and without hearing aids before surgery. Generally, we consider the optimal period of speech development to be under 6 years of age, with brain plasticity decreasing significantly from 7 to 12 years of age and gradually approaching that of adults after 12 years of age. Based on post-operative follow-up and sound field assessments documented in the literature, researchers believe that the younger the pre-speech adolescent with profound hearing loss is, the better the cochlear implant, and that there is a significant difference in speech comprehension during the post-operative recovery period depending on the age at implantation. Some audiologists have suggested that cochlear implantation at an older age of 5.1 to 7.9 years is associated with poorer post-operative auditory speech rehabilitation, while cochlear implantation at an older age of 8.0 years or more is associated with poorer rehabilitation for the prelingually profoundly hearing impaired. However, some children in China do miss the best time to get a cochlear implant for various reasons. In this context, we need to rethink cochlear implantation for adolescents with prelingual hearing loss, as the number of older prelingually profoundly hearing impaired individuals who expect cochlear implants is increasing due to social, academic, and work demands. ZeitlerDM et al. evaluated the outcome of cochlear implants in prelingual hearing impaired individuals aged 11 to 17 years and found significant improvements in speech, hearing, daily living, physical and social functioning. This suggests that cochlear implantation in prelingual hearing impaired patients beyond the optimal age of implantation can still be effective. Therefore, cochlear implants are still encouraged for older prelingual hearing impaired patients when economic conditions permit, and the younger the patient is at the time of implantation, the better the outcome. Many foreign studies have concluded that cochlear implants are more effective if they are preceded by a history of hearing aid rehabilitation for at least 3 months. For individuals with profound prespeech hearing loss, researchers speculate that the stimulation of the speech center through residual hearing after hearing aids may contribute to auditory language rehabilitation after cochlear implantation, but further research is needed to confirm this theory. There are many other factors that influence the outcome of cochlear implantation, and for older adolescents and adults, the implant recipient’s expectations for the postoperative period are particularly important. Establishing reasonable and appropriate expectations will help the hearing impaired to receive timely and effective postoperative speech rehabilitation, and it is recommended that the focus be on longitudinal comparisons of outcomes for the hearing impaired themselves, rather than horizontal comparisons with other hearing impaired individuals with better rehabilitation outcomes, which will help the hearing impaired to build confidence and thus further improve rehabilitation outcomes. In conclusion, cochlear implantation is still effective for adolescents with prespeech profound hearing loss, and the longer the implantation time, the better the rehabilitation effect, and the younger the age at the time of implantation, the faster the postoperative language ability progress. Therefore, early cochlear implantation is still recommended for older prelingually profoundly hearing impaired patients.