Hart and Risley (1995) found evidence of a 30-million-word gap by the age of three between children experiencing the mostand the least spoken input. In the present study, we investigated the magnitude of differences in amount of linguistic inputin environments of a clinical population: children with cochlear implants. We identified a 30 million word gap over threeyears between children who received the most and the least spoken language input in their home environments. Further,we identified a 22 million word gap in numbers of infant-directed spoken words experienced by children hearing the mostand the least input. Together, the results suggest that some children with cochlear implants may be doubly disadvantagedin acquiring spoken language, due to the degradation of the speech signal associated with electronic hearing, and due tothe dearth of quality linguistic input in sufficient quantity in their language environments.