Because the meaning of literacy is changing, teachers lack understanding of how to teach older students the skills they need to read and be proficient in an ever-changing digital world. Moreover, only 34% of U.S. 8th graders read at the proficient level, according to the 2015 National Assessment of Educational Progress. Therefore, the purpose of this qualitative case study was to investigate the process of how middle school teachers in a large urban district in Florida understand and integrate visual literacy for teaching comprehension in their lesson plans and class instruction after completing professional development and subsequent curricular support on visual literacy. Participants were 3 teacher educators in a South Florida district who received 6 weeks of professional development on incorporating visual thinking strategies into lesson plans. Data from interviews, reflective journals, and participant lesson plans were used to answer the overarching research question: How do middle school teachers describe and integrate lessons involving visual literacy and visual thinking strategies to improve struggling students' comprehension after completing professional development in visual literacy?Participants were open to learning new strategies. They were eager to learn more each week and constantly used their frame of reference from their classrooms in thinking of ways to employ the strategies. Eight specific themes were identified from participant data: (a) vocabulary instruction, (b) student engagement, (c) prior knowledge and pictures, (d) use of novels in theme-based units, (e) student-created visual products to show comprehension, (f) deeper understanding of text, (g) collaboration, and (h) critical thinking skills. A comprehensive program that addresses visual literacy would provide a foundation for improving comprehension. Employing visual literacy and visual thinking strategies has the potential to provide a foundation for comprehension processing prior to, during, and after a student reading a text. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]