Purpose: Attaining speech accuracy requires that children perceive and attach meanings to vocal output on the basis of production system capacities. Because auditory perception underlies speech accuracy, profiles for children with hearing loss (HL) differ from those of children with normal hearing (NH). Method: To understand the impact of auditory history on emergence of speech capacities, the authors compared consonant-vowel (CV) syllable accuracy in early words in 4 NH children and 4 children with HL who received cochlear implantation (CI) before age 2 years. Participants were video-recorded monthly for 6 months following word onset. CV vocalizations were coded perceptually with broad phonetic transcription. Observed-to-expected ratios of CV productions and accuracy were tested with chi-square analysis. An ordered multinomial model tested level of accuracy, including both accuracy and error patterns. Results: Most frequently produced sequences were most accurately produced across group and time. NH children were more accurate overall than children with CI. Both groups improved accuracy over time by decreasing partially accurate productions (accurate consonant-inaccurate vowel). Both groups favored CV patterns with compatible place of articulation between consonant and vowel in absolute frequency and level of accuracy. Conclusion: Differences in emergence of CV syllable accuracy arise from differences in auditory perception between the NH and CI groups.