In the current study, we explore the influence of orthographic knowledge on phonological awareness in children with cochlear implants and compare developmental associations to those found for hearing children matched for word reading level or chronological age. We show an influence of orthographic knowledge on syllable and phoneme awareness in deaf and hearing children, but no orthographic effect on rhyme awareness. Nonorthographic rhyme awareness was a significant predictor of reading outcomes for all groups. However, whereas receptive vocabulary knowledge was the most important predictor of word reading variance in the cochlear implant group, rhyme awareness was the only important predictor of word reading variance in the reading level matched hearing group. Both vocabulary and rhyme awareness were equally important in predicting reading in the chronological age-matched hearing group. The data suggest that both deaf and hearing children are influenced by orthography when making phonological judgments, and that phonological awareness and vocabulary are both important for reading development.