There has been a significant and consistent increase in the numbers and proportion of students disclosing disability at enrollment in Australian higher education. The growth in student numbers has paralleled the introduction and enhancement of legislative and policy instruments that enable their participation. Whilst significant changes are evident in higher education institutional and policy contexts which demonstrate a willingness and commitment to enabling student participation, significant challenges remain in implementing services that support the participation, learning and success of students experiencing disability. The intersection between disability and higher education results in complex problems for which innovative solutions are required. This complexity is evident in the participation of those with profound hearing impairments. Service delivery methods that function effectively in community or other educational contexts are not adequate in higher education contexts. The sophisticated language and conceptual requirements of higher education are not well accommodated through the dominant support models of Auslan (Australian sign language) interpreting and notetaking. In this context, a support model involving the provision of live captions has been successfully trialled at an Australian university. This is now the dominant mode of support for the university's students with profound hearing impairments. The implementation of live captioning, and its adoption at other institutions within Australia, provides insights into practices that are effective in enabling student participation in higher education.