This qualitative study analyzed interactions between clinicians and a male child, aged 5 years 9 months old, with significant phonological as well as language deficits within a meaning-based phonological intervention implemented over a nine-month period. Play-based intervention strategies were presented in activities that varied in communicative complexity. The clinician, along with graduate-student assistants, frequently modeled and elicited target word productions as they interacted with the child in routines and scripted play contexts. Transcriptions of interactions were analyzed using a conversational analysis that explored engagement and participation, turn taking, and linguistic complexity of utterances produced in adjacent turns. The analyses illustrated ways in which the clinicians structuring of the activities influenced the child's participation. The turn taking exchanges were topically related when dealing with shared, immediate context. The reciprocal nature of the turn taking exchanges, and the child's grammatical productions were analyzed. The study suggests that contextualized intervention can make speech sound production relevant for children with phonological production as well as language deficits.