The conversational skills of children with hearing impairment have been found to resemble those of children with learning disabilities and are often inadequate for successful mainstreaming. The pragmatic skills of children with hearing impairment can be enhanced by maximizing the opportunities to practice conversational behaviors in therapy. The purpose of this article is to discuss the use of clinician-designed thematic role-play scenarios during auditory training to enhance the conversational skills of preschool and elementary school children.