The social interactions (n = 576) of 11 children who were medically fragile and developmentally delayed (MF/DD) were analyzed. Children interacted with a range of 5–23 people (M = 13.82) during the course of a school day, averaging 52 social encounters (range, 27–75). Most interactions (83.5%) were with adults and often occurred while the adults were providing care and teaching. Only 4.2% of social encounters were initiated solely for play, and 7.2% included play with another activity. Network members initiated most interactions, and 60% were reciprocal. Children who are MF/DD require assistance and support to play and interact with other children.