Objectives <p>To evaluate the effects of cochlear implantation on auditory-verbal and spatial-auditory abilities of hearing-impaired children.</p> Methods <p>A total of 406 hearing-impaired patients, ranging from 1 to 13 years, were categorized into six groups: 1–3 years (7), 3–5 years (34 ), 5–7 years (62), 7–9 years (94 ), 9–11 years (138 ), and 11–13 years (71 ) groups. Auditory-verbal ability and speech-space hearing quality were assessed using the Categories of Auditory Performance (CAP), the Speech Intelligibility Rating (SIR), and the Chinese version of the Speech, Spatial, and Other Qualities of Hearing Scale-Parental (SSQ-P). The auditory and speech abilities of cochlear implant patients at 1–3, 3–5, 5–7, 7–9, 9–11, and 11–13 years after start-up were compared.</p> Results <p>A longer duration of cochlear implant use within 1–9 years of start-up was associated with higher hearing ability and speech intelligibility scores of the hearing impaired patients (<i>p</i> &lt; 0.001). The dimensions of speech perception and auditory quality in the SSQ-P questionnaire were also significantly improved (<i>p</i> &lt; 0.001). Auditory ability, speech intelligibility, and speech-spatial hearing quality of hearing-impaired patients showed a decreasing trend within 9–13 years of start-up. Auditory ability affects speech perception and speech function affects 2 dimensions of speech perception and hearing quality.</p> Conclusions <p>Children with cochlear implants showed a significant improvement in auditory-verbal ability up to 9 years after start-up. Therefore, cochlear implantation has significantly improved auditory speech and spatial hearing abilities in children with hearing loss, and it is suggested that 9 years after implantation can be an important reference stage for whether to proceed with device renewal.</p>