The purpose of the present study was to develop a structural model of reading based on the Lexical Quality Hypothesis (Perfetti & Hart, 2002). Data from a 4-year longitudinal study of Dutch primary school children with and without hearing loss were used to conduct an exploratory analysis of how lexical components (i.e., decoding skills, lexical decision, and lexical use) relate to one another and to reading comprehension. Our structural model supports a positive role of the quality of the mental lexicon for reading comprehension. Furthermore, it was possible to apply the same conceptual model of reading development to both groups of children when incorporating hearing status as a grouping variable. However, a multigroup comparison model showed that the predictive values of the relations between the different tasks differed for the two groups.