In general, school-age children with significant hearing loss demonstrate poorer literacy skills than their typically hearing (TH) peers. However, it is often difficult to infer from research findings which individual factors contribute to overall learning outcomes, given the high degree of heterogeneity in the hearing-impaired population. Since the development of any specialised intervention is based on evidence about the strengths and weaknesses of the targeted group, gaps in research arising from population variability have clinical and educational significance. Of the broader population of children who are deaf and hard of hearing, the research presented in this thesis pertains to a homogeneous group of beginning readers with significant bilateral hearing loss, who use cochlear implants (CIs) and communicate via solely spoken language. A psycholinguistic approach, founded on existing theoretical models, informed the collection and analysis of research findings in this thesis, which has thus allowed for specific interpretations as to the skills underlying reading and writing outcomes in children with CIs. iii Declaration by author This thesis is composed of my original work, and contains no material previously published or written by another person except where due reference has been made in the text. I have clearly stated the contribution by others to jointly-authored works that I have included in my thesis. I have clearly stated the contribution of others to my thesis as a whole, including statistical assistance, survey design, data analysis, significant technical procedures, professional editorial advice, financial support and any other original research work used or reported in my thesis. The content of my thesis is the result of work I have carried out since the commencement of my higher degree by research candidature and does not include a substantial part of work that has been submitted to qualify for the award of any other degree or diploma in any university or other tertiary institution. I have clearly stated which parts of my thesis, if any, have been submitted to qualify for another award. I acknowledge that an electronic copy of my thesis must be lodged with the University Library and, subject to the policy and procedures of The University of Queensland, the thesis be made available for research and study in accordance with the Copyright Act 1968 unless a period of embargo has been approved by the Dean of the Graduate School.