Deaf and hard-of-hearing children struggle with spoken language acquisition, often exhibiting delays and deficits (Ching et al., 2013), alongside variable spoken language outcomes (Pisoni, Kronenberger, Harris, & Moberly, 2018). Guidelines suggest that for best spoken language outcomes, children with hearing loss are screened by 1 month, diagnosed by 3 months, and begin services for hearing loss by 6 months. Although early diagnosis and intervention have been shown to predict better spoken language (Diego-Lazaro et al., 2019; Yoshinaga-Itano et al., 2018), we found that less than 40% of children receiving state services for hearing loss (n = 85) met these guidelines. Children with additional comorbidities were less likely to receive early diagnosis and intervention, although they’re at greater risk for language delays. We explore language outcomes for children with hearing loss and highlight the importance of hearing screening and service coordination for children with additional comorbidities.