This study evaluated the impact of a comprehensive reading program enhanced with sign language on the literacy and language skills of three elementary school students with intellectual and developmental disabilities. Students received individual and small group comprehensive reading instruction for approximately 55 minutes per session. Reading instruction combined the PCI Reading Program with literacy and language activities to target concepts of print, phonemic and phonological awareness, sight word recognition, vocabulary and oral language, and comprehension. Results indicated that all three participants showed growth in their literacy skills, specifically in the areas of letter identification, letter-sound knowledge, sight word knowledge, receptive vocabulary, and listening comprehension. Implications for future research and educational practices for utilizing comprehensive reading instruction are discussed. (Contains 2 figures and 2 tables.)