A series of phonemic awareness (PA) and single-word reading tasks, which did not require spoken responses, was developed for administration to people with complex communication needs. The aims of the study were to (a) determine the construct validity of the PA tasks and (b) investigate the relationship between PA and single-word reading in adults with complex communication needs. Forty adults with physical and/or intellectual disability were administered these tasks and a standardized measure of receptive spoken vocabulary. In assessing construct validity, data from all participants, including those who used speech, were included in a factor analysis, which indicated that the PA tasks loaded onto a single factor. This factor was interpreted to be PA. The relationship between PA and single-word reading in adults with complex communication needs was determined using correlational and multiple regression analyses of data from 34 of the original participants who did not have functional speech skills. These analyses indicated that receptive spoken vocabulary accounted for a significant amount of variance on most tasks. Additional significant variance in performance on the single-word reading tasks was accounted for by performance on the PA tasks, in particular, Nonword Blending and Phoneme Analysis. These results indicate that the tasks developed provide a valid means of assessing PA and single-word reading skills. In addition, the results indicate that adults with complex communication needs demonstrate the same positive association between PA and reading as has been found in other groups of individuals with and without disability.