Prior research indicates that pre-kindergarten programs have not fully closed the gap between low-income and middle-income children regarding phonological awareness and vocabulary knowledge, two key predictors of later reading success. The current study examined Head Start teachers' views of and challenges in implementing instruction to improve children's sound and word skills. Teachers' descriptions of their instructional strategies emphasized more planning of explicit instruction for phonological awareness than for vocabulary knowledge. Letter knowledge was cited often as a central element of sound and word instruction. Teachers expressed uncertainties about research-based practices in teaching letter-sound associations and novel words to children with limited English language skills. Findings suggest that teachers may benefit from individualized approaches to professional development that emphasize the developmental continuum of phonological awareness and strategies of intentional instruction in vocabulary knowledge. Findings also suggest that the status of vocabulary knowledge needs to be improved in learning standards that currently include few or no indicators related to children's understanding and use of novel words.