While Deaf students are not typically classified as English as a second language (ESL) students, the majority of deaf students first become fluent in a signed language, making them ideal candidates for ESL research. This case study has been designed to explore the ways in which one method of ESL reading instruction, known as modified guided reading (MGR), affects the language acquisition process, and resulting reading comprehension level, of a deaf student over eleven weeks. The study documented the student’s language acquisition development both in American Sign Language (ASL) and in English, as well as tracked the student’s growth in reading comprehension, metalinguistic awareness, and visual attention skills. The Accelerated Reader (AR) program, benchmark testing, and daily observations were used to measure growth. Findings of the study suggest that the ESL methods implemented through MGR positively impacted the student’s language acquisition process, reading comprehension level, metalinguistic awareness, and visual attention skills. Results showed an increase in all three of the student’s AR scores as follows: 31% in reading level, 13.1% in number of words read, and 13.2 % in comprehension test scores. Observations and benchmark testing revealed increased metalinguistic knowledge in word, syntactic, and pragmatic awareness. Visual attention skills were found to be the key element in allowing reading comprehension to take place and strategies for improving these skills were found to be a necessary part of the MGR process.