This study investigated children’s acquisition of three aspects of an early literacy curriculum, Foundations for Literacy (Foundations), designed specifically for prekindergarten students who are deaf or hard of hearing (DHH): syllable segmentation, identification of letter-sound correspondences, and initial-sound identification. Three prekindergarten students with hearing loss, who used some form of signed communication, participated in this multiple baselines across content design study. Phonological and phonics activities are embedded within the Foundations curriculum, which is built around strong visual manipulatives to provide access to phonemic content. A Visual Phonics (VP) strategy was incorporated into two of the three targeted outcomes. Results indicated that the signing DHH students in this study were able to learn syllable segmentation, letter-sound correspondences, and initial sounds.