BackgroundThe FOCUS© is a new outcome tool for use by both parents and clinicians that measures changes in the communicative participation skills of preschool children. Changes in communicative participation skills as measured by the FOCUS were compared across three groups of children: those with speech impairments only (SI), those with language impairments only (LI) and those with both speech and language impairments (S/LI).MethodsParticipating families (n = 112, 75 male children) were recruited through 13 Canadian organizations. Children ranged from 10 months to 6 years 0 months (mean = 2.11 years; SD = 1.18 years) and attended speech-language intervention. Parents completed the FOCUS at the start and end of treatment. There were 23 children in the SI group, 62 children in the LI group and 27 children in the S/LI group. The average amount of the children's therapy varied from 7 to 10 h.ResultsThe FOCUS captures changes in communicative participation for children with a range of communication disorder types and severities. All three groups of children made clinically important improvements according to their FOCUS scores (MCID ≥ 16 points). The FOCUS captured improvements in intelligibility, independent communication, play and socialization.ConclusionsThe FOCUS measured positive changes in communicative participation skills for all three groups of children after 7–10 h of speech-language therapy. An outcome measure that targets only specific speech and language skills would miss many of the important social function changes associated with speech-language treatment.

Both tools show promising evidence of reliability and validity in describing functional speech intelligibility for this group of typically developing Jamaican preschoolers.

The review revealed a dearth of measures in the pediatric speech-language literature that address Participation-based outcomes. The authors strongly advocate for the use of Participation-based outcome measures to detect meaningful change in the lives of children and families.

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O u tc o m e s and p re d icto rs in preschoolers w ith speech-language a n d /o r d e v e lo p m e n ta l m o b ility im p a irm e n ts AbstractThe purpose of this article is to describe communicative-participation outcomes measured by the Focus on the Outcomes of Communication Under Six (FOCUS®; Thomas-Stonell et al" 2 0 13) for interventions provided by speech-language pathologists (SLPs) in different community settings for preschoolers with speech-language impairments (Sp/LI) with and w ithout developmental mobility impairments (Ml). The predictive relationships between communicative-participation and (I) functioning-and-disability, and (2) contextual factors, was also investigated. Sixty-one preschoolers with Sp/LI and their parents participated. Twenty-six preschoolers were identified with Sp/LI and received speech-language interventions (Group I), 20 preschoolers were identified with Sp/LI and Ml and received speech-language interventions (Group 2), and 15 preschoolers with Sp/LI awaiting intervention served as waitlist controls (Group 3). Parents completed structured interviews about children's communicative-participation outcomes using the FOCUS® at three time points (pre intervention, post-intervention, and 3-months post-intervention) with an SLP. Only Groups I and 2 experienced statistically and clinically meaningful communicative-participation outcomes over time as measured by the FOCUS®. Pre-to post-intervention communicative-participation was predicted by functioning-and-disability and contextual factors, initial social skills and intervention status, respectively. Post-intervention to 3-month post-intervention scores were also predicted by functioning-and-disability and contextual factors, risk status (Sp/LI only, Sp/LI+developmental Ml) C o rre s p o n d in g a u th o r: