Emergent-literacy skills are frequently taught within social interactions in preschool classrooms such as shared book reading. Children with impaired language and/or social engagement may have difficulty accessing these learning opportunities. Therefore, we sought to investigate the relationship between book-reading orientation during a teacher-led shared book reading activity and emergent-literacy skill development across three groups of preschool children; autism (n = 22), developmental language disorder (DLD; n = 23), and typical development (TD; n = 58). The children with autism demonstrated less book-reading orientation than their DLD and TD peers. Book-reading orientation was a significant predictor of residualized gains in print-concept knowledge and phonological awareness. Thus, book-reading orientation appears to play a critical role in preschooler’s emergent-literacy skill development.