Purpose. The primary purpose of this study was to assess whether very early access to speech sounds provided by the cochlear implant enabled children with severe to profound hearing loss to develop age-appropriate phonological awareness abilities during their preschool years. A secondary purpose of this study was to examine whether preschoolage children with cochlear implants develop age-appropriate skills in speech perception, speech production, general language, receptive vocabulary, and print knowledge; skills that are assumed to provide the foundation for or, minimally, to covary with phonological awareness. A third purpose of this study was to examine which of these factors contribute uniquely to the variance in the phonological awareness abilities of these preschoolers. Method. 24 children ages 36 to 60 months who had been utilizing their cochlear implant(s) for a minimum of 18 months (CI group) and 26 normal hearing peers (NH group) were enrolled in this study. Phonological awareness and print knowledge were assessed via the "Test of Preschool Early Literacy". Speech perception was assessed via the Play Assessment of Speech Pattern Contrasts test, a measure that examines perception of speech pattern contrasts. Speech production was assessed by calculating Percent Consonants Correct from children's productions on the "Goldman-Fristoe Test of Articulation-2". Total language and receptive vocabulary were assessed using the "Preschool Language Scale-4" and the "Peabody-Picture Vocabulary Test-4", respectively. Results: Children in the CI group were outperformed by their NH peers in the areas of phonological awareness, speech production, general language, and receptive vocabulary, but not print knowledge. For speech perception, the CI group consisted of significantly more non-perceiving children (children who demonstrated limited ability on the speech perception measure) than did the NH group. These non-perceiving children evidenced significantly delayed skills in each area except print knowledge as compared to the perceiving subgroup. Despite differences in performance outcomes between the CI and NH groups, some children in the CI group were able to demonstrate skills above the mean of the NH group in each of the skill areas assessed. Statistical analyses indicated that phonological awareness scores were correlated with speech perception, speech production, and oral language scores for children in the CI group and with oral language scores for children in the NH group. The lack of a significant correlation between speech perception and phonological awareness for the NH group was due to a ceiling effect in the speech perception scores. Regression analyses indicated that for the CI group, speech production did not uniquely predict any significant variance in phonological awareness scores after accounting for general language abilities. The opposite was also true; general language abilities did not uniquely account for any significant variance in phonological awareness scores after consideration of speech production abilities. That is, the variance was shared. For the NH group, speech production abilities did not account for any significant variance in phonological awareness scores. However, general language scores did account for significant variance in phonological awareness abilities for the NH group. Conclusions: This study indicates that age appropriate speech perception, speech production, oral language, and early literacy skills by school-age are reasonable goals for preschoolers who have been implanted for 18 months or more. However, the results in this study also indicate that many children with cochlear implants will lag behind hearing peers in these areas, making early language and phonological skills important areas of focus for programs of remediation. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]