Children with Down syndrome (DS) often exhibit delays in cognitive and linguistic development. In response to the increasing number of culturally and linguistically diverse populations with disabilities in the United States and need for evidence-based interventions with cultural adaptations, this study examined the effects of enhanced milieu teaching on targeted vocabulary acquisitions of four Korean American children with DS. Each child's language preference, linguistic developmental trajectory, and preferred play themes/toys were considered as core methods of cultural adaptation. The results indicated that the use of targeted vocabularies increased among all children with DS and were maintained at higher levels than baseline. Implications for teaching language skills to culturally and linguistically diverse children with DS are discussed.