EXPLORING COMMUNICATIVE PARTICIPATION OUTCOMES FOR PRESCHOOLERS WITH SPEECH AND LANGUAGE DELAYS

Abstract

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.