Children with isolated cleft of the lip and/or palate (iCL/P) are at increased risk for reading impairment. The purpose of this study was to evaluate the impact of early risk factors (hearing, speech, and early literacy) on reading performance compared to unaffected participants with average (uAR) and impaired (uIR) reading. Reading achievement and early literacy skills were evaluated across three groups (27 iCL/P, 32 uAR, and 33 uIR). All participants were males, ages 8-11 years old. Those with history of head trauma/injury or major medical/mental health conditions were excluded. Group differences in achievement and early literacy skills were evaluated with ANCOVAs. Participants with impaired reading achievement (at or below 25th Percentile) were identified. Medical record reviews for participates with iCL/P were conducted and audiology and speech ratings recorded. Correlations were calculated between achievement, early literacy, hearing, and speech. Participants with iCL/P had significantly elevated risk for reading impairment (37%); this risk differed by cleft type (0% iCL, 55% iCLP, and 60% iCP). Achievement for participants with iCP was similar to the uIR group. Early literacy risk resulted in lower achievement scores for both iCL/P and unaffected participants. History of inadequate hearing and speech did not significantly impact early literacy or achievement measures. There is a high risk of reading impairment for children with iCL/P-highest for those with iCLP and iCP. Early literacy predictors of reading outcome are similar for iCL/P and idiopathic dyslexia. Current screening and intervention methods are supported.