This study compared the benefits of a child-centered therapy approach emphasizing child-initiated play interactions within a structured therapy environment to those of a therapist-directed, structured sensorimotor therapy approach in 12 preschool children with sensorimotor dysfunction. Each child received a pretest, 8 weeks of intervention (A or B) provided once weekly for a 1-hr session, a retest, 8 weeks of intervention (B or A) provided once weekly, and a final retest. A case study methodology was used to evaluate outcome data. Structured sensorimotor therapy was more useful than child-centered therapy in promoting gross motor skills, functional abilities (i.e., self-care), and sensory integrative functions. Child-centered therapy appeared to promote fine motor skills better. Although there were no differences in the two therapies for gains in play, attention, and behavior, variables such as temperament, attentional abilities, family stress, severity of sensorimotor delay, and whether the child had received treatment before seemed to affect which therapy was more beneficial for behavior, play, and attention. The effect of the findings on therapeutic practice is discussed.