This study described the communication and spoken language development of a Japanese girl with profound hearing loss who used a cochlear implant from 19 months of age. The girl, Akiko, was born in Belgium where her family was living at that time. After she was identified as deaf at birth, she and her parents were provided with support services. The family relocated to Japan when Akiko was 1 year 5 months of age. When she was 1 year 6 months of age Akiko underwent cochlear implantation. The cochlear implant device was activated when Akiko was 1 year 7 months of age. The parents routinely made video recordings of Akiko interacting with family members and teachers at home and at school. The video recordings taken by the parents used as the data for this study contained scenes of Akiko from the time she was 3 months of age until she was 4 years 11 months of age. Micro-ethnographic methods were used to analyze the dynamics and development of selected communicative interactions over this age span of fifty-six months. The original pool of video recordings contained 213 scenes.As a result of video viewing and editing, Akiko’s communication development was found to follow expected patterns of development as described by other child language researchers of children with normal hearing. There were seven demarcations that represent Akiko’s communication and spoken language development: 1) perlocutionary, 2) transition of perlocutionary to illocutionary, 3) illocutionary, 4) transition of illocutionary to locutionary, 5) locutionary, 6) dialogue, and 7) narrative.