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The purpose of this study is to examine the results of implementing phonologically based reading instruction with students educated in a sign bilingual setting. Over the three-year study period, 127 students received remedial phonemic awareness and phonics instruction supplemented by Visual Phonics. While there was a range in degree of hearing loss among study participants, approximately 80% were in the severe to profound range (i.e., 80 dB or greater), and nearly 40% had one or more documented disability other than Speech and Language in addition to their hearing loss. Data on individual student characteristics (e.g., age, grade, degree of hearing loss) and from curriculum-based measures will be analyzed using a multidomain latent difference score structural equation model with time-independent covariates.