Historically, children with hearing loss (HL) are often poor readers. In this article, the authors present two divergent groups of children with HL who have better than average literacy outcomes, children with Pervasive Exposure to Sign Language (PESL) and children who are Auditory-Verbal Communicators (AVCs). Outside-in and inside-in factors contributing to literacy development in the two groups of children are discussed with an emergent literacy perspective. Effective intervention strategies that can be used with all children with HL are highlighted.