Objective: Unilateral hearing loss has been linked with academic, behavioral, and psycholinguistic difficulties (Lieu, Tye-Murray & Fu, 2012). The presented case explores how a child's attentional difficulties, language delay, and emotional dysregulation could be better explained by unilateral hearing loss rather than the original diagnosis of ADHD Inattentive Type. Method: The client was a 9-year-2-month-old, English monolingual, Latina recently diagnosed with unilateral hearing loss. Presenting problems included: angry emotional outbursts, attentional difficulties, oppositional defiance, academic difficulties with math and reading, memory impairment and disorganization, aggressive behavior, pulling out eye lashes, bed wetting, and mild weigh gain. Comprehensive and culturally sensitive neuropsychological instruments were used to obtain information regarding the client's current functioning. This included testing of executive function done both with and without Concerta (18mg, qam). Results: Neuropsychological test results revealed average overall cognitive ability but relative weakness in language, reading comprehension, psychomotor speed, and some areas of memory and executive functioning. Multiple sources indicated client's attentional difficulties in group versus one-on-one settings. Client's performance on executive function tasks were comparable with or without medication and indicated no difficulty in sustained attention or inhibition. Conclusion: Hearing loss likely contributed to the aforementioned deficits, client's passive and anxious performance approach, and her overall socioemotional functioning. This case illustrates the value of differentiating between patterns of attentional difficulties and subsequently addressing the unilateral hearing loss rather than using classic treatments of ADHD.