This review article starts with an overview of changing education paradigms and the literature on cognitive and linguistic relationships in imaginative play related to comprehension of oral and written texts. Strategies for developing the cognitive and linguistic foundations for text comprehension through play are described. A review of current literature on children who are deaf or hard of hearing (DHH) indicates that many of them are at risk for deficits in imaginative play and text comprehension related to deficits in language, cognition, theory of mind, and social-emotional skills. The article concludes with description of a play-based educational program that was implemented with preschool children who are DHH. It is an example of how play-based interventions could be implemented with other populations facing language and literacy challenges.