Deaf and hard of hearing (d/Dhh) children frequently have delayed language; yet limited research exists on interventions to facilitate linguistic development in the classroom (Fung, Chow, & McBride-Chang, 2005). Dialogic reading is an evidence-based practice that has resulted in significantly improved language skills (Towson, Fettig, Fleury, & Abarca, 2017; Whitehurst, Arnold, et al., 1994). The present study used case study and design research methods with three elementary school teachers to identify challenges to implementing dialogic reading and necessary adaptations for d/Dhh students. Primary data sources were collaborative meetings with teachers and these meetings' transcripts. Additional sources were video-recordings of dialogic reading. Teachers were found to be hindered by insufficient knowledge about language delays and elements of implementation; specifically, adaptations for d/Dhh students competed with curricular responsibilities. It is concluded that teachers should receive better preparation and support for the complex, multifaceted task of instruction.