Reading comprehension is a crucial skill for success across several academic domains and for everyday functioning, yet compared to word reading, longitudinal studies examining the typical and atypical development of this skill are scarce. This dissertation is comprised of two studies that explore reading skill development, with an emphasis on reading comprehension, in a sample of children with Spina Bifida Myelomeningocele (SBM) and a typically developing group. Participants were recruited in infancy to participate in a larger study on the impact of SBM on learning and tested at several timepoints across the first ten years of life. In study one, outcome and growth in word reading, reading fluency, and reading comprehension were explored across three time points at school-age (age 7.5, 8.5 & 9.5). This was followed by analyses to test the relation of preschool oral language and kindergarten phonological processing skills to later outcomes in reading. Results were consistent with hypotheses that suggest a causal relation between early oral language skills and later reading comprehension, while also incorporating the roles of phonological awareness and word reading into the model. Study two is an examination of the cognitive-developmental origins of an important text-level skill, bridging inference making, and its connections to reading comprehension. Results provided evidence that three preschool cognitive abilities (working memory/inhibitory control, oral comprehension, and narrative recall), could partially explain the relation between group and bridging inference skill and that each of these abilities at 36-months had an indirect effect on reading comprehension at age 9.5 through bridging inference skill. Findings from both studies contribute to an understanding of comprehension development, blending theories from the developmental, cognitive, and neuropsychological literatures. Overarching theoretical and clinical implications are discussed in the final chapter.