Effective management of children who are deaf or hard of hearing and faced with the added challenge of Attention Deficit Disorder requires a comprehensive and coordinated spectrum of services. A complex array of underlying or associated factors can mimic, cause, or exaggerate the symptoms. Careful diagnosis is thus essential and is the prerequisite for developing effective intervention. In this article, we present a practical approach to the problem, based on experience with a model treatment program at a residential school for the deaf. Suggestions are provided regarding the diagnostic work-up of children presenting with attention problems. Management approaches are discussed for the classroom, home, and residential area as well as specialized therapeutic intervention and the use of medication. A model for implementing a treatment program in a school is presented, and future challenges are discussed.