This longitudinal study used piece-wise growth curve analyses to examine growth patterns in oral reading fluency for 1,991 students with speech impairments (SI) or language impairments (LI) from first through third grade. The main finding of this study was that a diagnosis of SI or LI can have a detrimental and persistent effect on early reading skills. Results indicated differences between subgroups in growth trajectories that were evident in first grade. A large proportion of students with SI or LI did not meet grade-level reading fluency benchmarks. Overall students with SI showed better performance than students with LI. Reading fluency performance was negatively related to the persistence of the SI or LI; the lowest performing students were those originally identified with SI or LI whose diagnosis changed to a learning disability. The results underscore the need to identify, monitor, and address reading fluency difficulties early among students with SI or LI. (Contains 5 tables and 3 figures.)