Purpose: The purpose of this study was to examine the relationships among variables that may contribute to poor phonological awareness (PA) skills in preschool-aged children with speech sound disorders (SSD). Method: Ninety-five 4- and 5-year-old children with SSD were assessed during the spring of their prekindergarten year. Linear structural equation modeling was used to compare the fit of 2 models of the possible relationships among PA, speech perception, articulation, receptive vocabulary, and emergent literacy skills. Results: Half the children had significant difficulty with speech perception and PA despite demonstrating receptive language skills within or above the average range. The model that showed the best fit to the data indicated that speech perception is a pivotal variable that has a direct effect on PA and an indirect effect that is mediated by vocabulary skills. Articulation accuracy did not have a direct impact on PA. Emergent literacy skills were predicted by PA abilities. Conclusions: Children with SSD are at greatest risk of delayed PA skills if they have poor speech perception abilities and/or relatively poor receptive vocabulary skills. Children with SSD should receive assessments of their speech perception, receptive vocabulary, PA, and emergent literacy skills. (Contains 2 tables and 3 figures.)