Objectives: To examine predictors of syllable extraction proficiency, a prerequisite forchildren with hearing impairments progressing from spoken to written language by theKanazawa Method.Background: The rates of delayed language acquisition in children with hearingimpairments have remained unchanged despite increased use of cochlear implants. Childrenborn with hearing deficiencies do not receive sufficient auditory inputs, which contributesto delayed acquisition of spoken language. As spoken language is the springboard towritten language, such children are likely to experience delays in acquisition of syllableawareness and written language when taught in the same way as children without hearingimpairments. However, most research on syllable awareness in children with hearingimpairments in Japan is related to studies targeting school-age children and later. Therefore,it remains unclear how to manage syllable awareness problems in pre-school-age children.Methods: This study was conducted on 68 children with hearing impairments, between 4 and6 years of age, diagnosed by the Kanazawa University Hospital with congenital deafness beforethe age of 4 years and receiving outpatient language instruction. To examine the predictors ofsyllable extraction scores, we performed multiple-regression analysis with syllable extraction asthe dependent variable and age, unaided hearing level, and scores for remaining language skills(auditory word comprehension, syllabification, syllable extraction, written language characterrecognition, and written language sentence comprehension) as independent variables.Results: Stepwise regression analysis showed that written language character recognitionscore, age, and auditory word comprehension score contributed to the syllable extraction score.Discussion: The relationship between syllable extraction proficiency and age was consistentwith previous reports. Early intervention targeting character recognition and auditory wordcomprehension assisted the teaching of written language and improved syllable awarenessin children with hearing impairments. The results of this study indicated that early-stageintervention in written language character recognition and auditory word comprehension isan effective method of teaching children with hearing impairments to facilitate acquisitionof written language and the development of syllable awareness. The vocabulary and syllableawareness acquired by exposure to a combination of spoken language, Japanese sign language,and written language can be easily transferred to speechreading. Using the Kanazawa Methodto facilitate understanding of the structure of Japanese language can help children with hearingimpairments to acquire syllable extraction proficiency, regardless of their unaided hearing level
