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The purpose of the study reported on in this paper was to design and test multimedia for deaf and hard of hearing (DHH) learners. The study focused on counting, addition and subtraction with grade one (age 7) DHH learners in Thailand. The multimedia created for the study was informed by design considerations for DHH learners of arithmetic and aimed to minimize cognitive load. Testing took place over a period of 16 weeks during which learners alternated between 2 and 3 week sessions of one hour per day with multimedia (numbers 1–10) versus 2–3 week sessions of one hour per day with the teacher (numbers 11–20). Results of the design included features such as non-essential use of text, reliance on non-symbolic objects, user control, and signals to relevant content. Results of testing showed that learning with multimedia resulted in higher scores than learning with the teacher (Z = 4.545, p = 0.000). Post-intervention interviews highlighted the role of motivation, ease of comprehension and independent learner control of the multimedia. The conclusion highlighted the need for multimedia design principles that reflect a more inclusionary focus on children with special needs such as those featured in this study.