Phonological processing is an important contributor to decoding and spelling difficulties, but it does not fully explain word reading outcomes for all children. As orthographic knowledge is acquired, it influences phonological processing in typical readers. In the present study, we examined whether orthography affects phonological processing differently for children with current reading difficulties (RD), children with a history of reading difficulties who are currently presenting with typical word reading skills (Hx), and children with typical development and no history of reading difficulties (TD). School-aged children completed a phonological awareness task containing spoken words and pictures while eye movements were recorded. In this task, children had to pair a spoken stimulus word with one of four pictures that ended with the same sound. Within the task, stimulus-target picture pairs varied in the congruency and consistency of the orthographic and phonological mappings of their final consonant sounds. Eye movements revealed that children with typical word reading (the Hx and TD groups) showed better discrimination of the target from the foils compared to peers with underdeveloped word reading skills. All children were more accurate when stimulus-target pairs were congruent and consistent than when they were incongruent or inconsistent. Orthography plays an important role in the completion of phonological awareness tasks, even in the absence of written words and for children with a wide range of reading abilities. Results highlight the importance of considering orthography during interventions for phonological awareness and word reading.