Studies of children with early-acquired brain damage have noted limitations on language development following such damage and have raised questions regarding the process by which these children acquire language skills. The purpose of this study was to examine the effects of perinatally acquired brain damage on early language abilities and on lexical development through the use of standard assessments, language samples, and a miniature linguistic system approach to teach a novel lexicon. Four children, ages 26-41 months, with localized, perinatal brain lesions documented on ultrasound or CT scan were selected for this study and were compared to 4 matched controls. The results show no differences in the pattern of scores and learning in children with right and left brain damage. With the exception of phonological development, subjects scored below controls on all formal language measures; however, the subjects often scored at or above test norms. Brain-injured subjects were similar to controls with respect to the number of novel words that they initially learned on comprehension and production tasks and the number that they consistently comprehended. Brain-injured subjects generally acquired fewer words when the criterion was consistent accurate production. Interestingly, subjects required more exposures to novel lexical items than did controls before reaching a given level of proficiency. Production seemed to be more difficult for all children, but more so for the brain-injured subjects. It appears that the effects of early damage have an impact on many aspects of language development and that these apparent deficits may reflect the child's need for greater exposure to language skills and structures before acquiring them.