This dissertation explored new ways of evaluating outcomes for preschoolers with communication disorders. It identified a need to evaluate outcomes as they relate to a child’s communicative participation and provided initial models for doing this. Chapter 1 provides the context for the dissertation, discussing the theoretical framework used, the literature on communicative participation outcomes, and Ontario’s Preschool Speech and Language Program (PSLP) and its program evaluation project (the setting for the studies presented in Chapters 4 & 5). Chapter 2 is a scoping review of the literature exploring the ways in which outcomes for preschoolers with communication disorders have been evaluated. It identifies a gap in the literature related to participation-based outcomes, and thus the need for the work presented in Chapters 4 and 5. Chapter 3 presents further evidence of both construct and predictive validity of the Communication Function Classification System (CFCS), the classification tool used for PSLP program evaluation. This tool was previously validated for use with children with Cerebral Palsy, and this study provides evidence of its validity with other groups of children. Chapter 4 explored communicative participation outcomes for preschoolers accessing PSLP services by developing growth curves that predict development of preschoolers’ communicative participation skills. The models provide a first look at the growth of those skills, and show that all children make meaningful change regardless of their communicative function. Chapter 5 added meaningful predictor variables (based on available data) to the previously defined growth curves (Chapter 4) and identified both demographic and intervention-specific variables that were predictive of growth. Predictors varied by level of communicative function, a new insight in the field. This work has clinical implications both within and beyond the PSLP. Chapter 6 discusses the clinical and research implications of this dissertation work as well as ideas for future directions of my research. / Thesis / Doctor of Philosophy (PhD) / The work presented in this dissertation explored participation-based outcomes for preschoolers with communication disorders. First, by completing a scoping review, I identified the need to explore participation-based outcomes for preschoolers with communication disorders. Participation-based outcomes are important and meaningful for families, but are not typically used in speech-language research or practice. I next modelled the development of communicative participation skills (how a child uses his/her communication to engage) for preschoolers with speech and language delays who were accessing services in Ontario’s Preschool Speech and Language Program (PSLP). Following this I identified both demographic and intervention-based predictors of that communicative ‘growth’. Development was modelled separately for children in five levels of communicative function using a reliable classification tool that I validated for use with this general community-based population. This work addresses a major gap in the speech-language literature and has important implications for clinicians, administrators and policy makers in the PSLP and beyond.

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