Text comprehension processes were investigated in children with hydrocephalus, a neurodevelopmental disorder associated with good word decoding, but deficient reading comprehension. In Experiment 1, hydrocephalus and control groups were similar in processes related to activating word meanings and using context to enhance meaning. The hydrocephalus group was poorer at suppressing contextually irrelevant meanings. In Experiment 2, the hydrocephalus group had difficulty integrating information from an earlier read sentence to understand a new sentence as textual distance between the two propositions increased, suggesting difficulty in reactivation processes related to comprehension. Results are discussed in relation to cognitive and neurocognitive models of comprehension.