Neuroplastic brain changes occur across the lifespan, with a sensitive period of maximal central auditory system plasticity present in early childhood. Early intervention for hearing loss with amplification and/or electrical stimulation allows for cortical auditory maturation and language acquisition whereas delayed intervention may result in persistent atypical auditory processing, language and cognitive delays. Hearing loss also results in cross-modal plasticity, in which deprived auditory brain regions are recruited and repurposed by other intact sensory systems. Cross-modal reorganization in children and adults is partially reversible with timely intervention. Brain based biomarkers of neuroplastic changes have the potential to aid clinical decision-making.