This paper discusses historical and contemporary issues regarding communication approaches for educating Deaf and hard of hearing (DHH) children in Ghana. Discussion of the communication approaches took into account a brief historical background to the development of formal education for DHH children in the country, academic achievement of DHH students at West African Senior Secondary Certificate Examination (WASSCE) over the past ten years, types of communication approaches for the DHH in Ghana, as well as legislation and relevant policy documents on educating DHH children in Ghana. The paper recommends the sign communication approach and other strategies which the authors believe will aid Ghana achieve the Sustainable Development Goal 4 for all DHH individuals.