Compliance with hearing aid use can be difficult to achieve with children. This difficulty can be increased when a child presents with other disabilities, such as developmental delays. Behavioral treatments, including differential reinforcement, might be one strategy for increasing compliance by these children. In the clinical scenario discussed, the hearing aid compliance of a young child with Sanfilippo syndrome was increased by systematic application of differential reinforcement and escape extinction. Treatment appeared to be successful both in the clinic and during a 1-month follow-up visit to the child's educational placement. (Contains 1 figure.)