The relation between play and communication was investigated in a sample of congenitally hearing-impaired, pre-school children. A sample of hearing children served as a guide for the 'normal' course of development. The children's use of their communication modalities during play and particularly play-extension, or the ability to extend beyond the immediacy of the play materials, was assessed. The same children had been assessed previously in terms of symbolic and non-symbolic play activities independent of communication. These findings served as a baseline for the present study. An observational and ethologically-based approach was adopted, with performance emphasized. Results indicated that the hearing-impaired children attained no 'move away from' the immediate play context although they used communication during play. Findings are discussed in the light of theoretical issues pertaining to the relationship between language and cognition, the role of gesture, and an oral-aural approach versus sign language. Clinical suggestions and implications for future research are offered.