Recent studies indicate children who are deaf and hard of hearing who use cochlear implants or hearing aids know fewer spoken words than their peers with typical hearing, and often those vocabularies differ in composition. To date, however, the interaction of a child's auditory profile with the lexical characteristics of words he or she knows has been minimally explored. The purpose of the present study is to evaluate how audiological history, phonological memory, and overall vocabulary knowledge interact with growth in types of spoken words known by children who are deaf and hard of hearing compared to children with typical hearing. Children with cochlear implants (n = 36) and hearing aids (n = 39) were compared to children with typical hearing (n = 47) at ages 4 and 6. Children participated in measures of phonological memory and vocabulary knowledge, inclusive of an experimental measure with words of varying phonotactic probability and neighborhood density. Results indicate that children with hearing aids and with cochlear implants tend to know fewer words across all lexical conditions than children with typical hearing. For children with cochlear implants, overall vocabulary knowledge was the best predictor of a mis-matched probability and density condition, whereas it was the best predictor of matched condition for children with hearing aids. Children with cochlear implants and children with hearing aids, then, appear to have different underlying skills that interact with the lexical characteristics of words to support vocabulary growth.