The purpose of this study was to find out how an adult can enable or hinder the realization of a disabled child’s agency in play interaction. We focused on the child’s play invitations, which were constructed as dispreferred by the adult. The data consisted of nine videotaped playing situations with five nurses and five disabled children in a children’s neurological ward. The microanalysis with interventionist applied conversation analysis focused on one playing situation between one nurse and one three-year-old boy with no spoken language. The nurse responded to the child’s play invitations constructed as dispreferred by her in three different ways. Two of them were about trying to control the situation, either through managing the child’s behaviour or by guiding the plot of the play. The third way of responding was negotiating through dialogical playing, which enabled the realization of the child’s agency. The findings can be utilized widely for developing child-centred practices.