Understanding the multilingual language context of deaf children's lives provides an essential knowledge base from which to develop the early support of children and families. Current models of early support tend to draw on Euro-Western understandings of the multilingual lives of families of deaf children and assume an established infrastructure around language and communication intervention. This paper examines the multilingual contexts of deaf children in Ghana; a low-resourced country in sub-Saharan Africa where the use of multiple local languages is a part of the eco-cultural context for early development, but where the early support of deaf children is under-resourced, and there is limited understanding of childhood deafness and the potential of sign language communication. Through interviews with caregivers of deaf children and the documentation of language biographies, we examine the proximal and distal influences on multilingual languaging and communication choices. We draw on Bourdieusian social theory to identify ways in which power and agency dynamically shape multilingual communication possibilities for deaf children and their caregivers, specifically in relation to the legitimised use of sign language among other local languaging practices. Implications for the development of context-sensitive models of early support for multilingual deaf children and their families are discussed.