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The ability to communicate is crucial to leading an independent life. Unfortunately, individuals from developing communities who are deaf and hard of hearing tend to encounter difficulty communicating, due to a lack of educational resources. We present findings from a two-year deployment of Speak Up, a suite of voice-powered games to motivate speech therapy, at a school for the deaf in India. Using ethnographic methods, we investigated the interplay between Speak Up and local educational practices. We found that teachers’ speech therapy goals had evolved to differ from those encoded in the games, that the games influenced classroom dynamics, and that teachers had improved their computer literacy and developed creative uses for the games. We used these insights to further enhance Speak Up by creating an explicit teacher role in the games, making changes that encouraged teachers to build their computer literacy, and adding an embodied agent.