This study determined the least mastered competencies of Grade 7 learners with difficulty hearing in Mathematics as the basis for developing the assistive technology lesson exemplar. Purposive random sampling was used. Teacher-made tests and validated researcher-made tests were administered. Suggestions were noted from focused group discussions. The assistive technology lesson exemplar developed was the multimedia that uses American Sign Language in the videos, closed captioning, videos, math manipulatives, and ICT applications during classroom activities. The assistive technology lesson exemplar developed was acceptable in all experts' categories. The level of competencies in Mathematics of Grade 7 learners with difficulty in hearing did not meet the expectations based on the K to 12 grading system. The level of competencies in Mathematics of Grade 7 learners with difficulty hearing are below their peers in mainstream education. Using the SETT framework and WATI Assistive technology checklist helped determine the appropriate assistive technology lesson exemplar. The assistive technology lesson exemplar developed was of great help to Grade 7 learners with difficulty in hearing in Mathematics.