Purpose: Interactive storybook reading (ISR) improves the picture labeling vocabulary of children who are deaf and hard of hearing (DHH). Vocabulary knowledge consistently predicts the later reading achievement of children who are DHH. In this study, ISR was modified to include teaching word meanings along with the vocabulary picture label. Method: A multiple probe across behaviors single-case experimental design was implemented to determine the effects of ISR with word meaning instruction on picture labeling and word meaning knowledge of 6 preschoolers who are DHH and use spoken English. The student and teacher participants engaged in ISR for 15-20 min a day, 4 days a week for 3 weeks. Results: A functional relation was established between ISR and the increase in the preschoolers' word labeling and meaning knowledge. The preschoolers' word knowledge was generalized and was maintained over time. Conclusions: ISR may be an effective vocabulary labeling and word meaning instructional strategy for young children who are DHH and use spoken English. Teachers and related service providers who work with this population may want to implement ISR with word meaning in 1-to-1 or small groups to individualize the target vocabulary and maximize the benefit. Future researchers should replicate this to expand its generalizability to other subpopulations of children who are DHH.