This study examined the effects of sound-field amplification (SFA) use for children who are deaf or hard of hearing (DHH) with additional diagnosed conditions enrolled in preschool and first and second grades in a rural district. Four focus children who are DHH with additional diagnoses were matched with hearing peers and observed for attending behaviors and latency in compliance to following routine directions with introduction of SFA. The study used a single-case multiple probe across participants design. All participants demonstrated improved attending behaviors and compliance to directions with SFA, with the focus children who are DHH with additional diagnoses showing stronger results than their hearing peers. Teachers indicated SFA was beneficial to the children who are DHH and they would use it again. SFA is an effective strategy to improve access to educational opportunities by increasing attending behaviors and promoting participation for children who are DHH with other diagnoses in special and general education preschool and first and second grades.