Participatory design is an approach that is built around collaboration with users through a process of coproduction, design and creation. Most interventions are designed with the expert clinician researcher as the starting point, who looks at theory, evidence and their knowledge to develop something. This follows a develop-assess-consult user sequence. Participatory Design turns this on its head by focusing on what users need first, before designing an intervention and testing its acceptability and feasibility. Importantly, this aligns with the advocacy from the disability rights movement expressed in the phrase “nothing about us without us”. The authors of this article outline three examples of Participatory Design use in speech and language therapy studies that have used qualitative methods to support this process. One example included using photo diaries and scenarios exploration to develop story grids with people with aphasia in intervention design. The other described videoing child-led activities and interviews with teachers and therapists to inform their intervention design. The authors advocate that Participatory Design includes many principles and practices with which qualitative researchers would be familiar, and which should apply as best practice within the design of new speech-language interventions and technologies.