Parents of 210 preschool children (age 2-5.7) and their clinicians were asked to describe their expectations for therapy and the changes they observed following treatment. Based on content analysis of the parents' and clinicians' responses, it was apparent that the comments aligned with the World Health Organization's (WHO) International Classification of Functioning, Disability and Health-Child and Youth version (ICF-CY) framework. Parents and clinicians observed positive changes across the ICF-CY domains of Body Functions, Activities and Participation and Personal Factors following therapy. Parents noted twice as many changes in the Participation and Personal Factors domains as clinicians. Parents described improvements in play, socialization, confidence and behaviour at home, school and in the community-changes not typically captured by other preschool speech and language outcome measures. New outcome measures need to be based on actual observations of change by both parents and clinicians to ensure that they measure a sufficiently broad-based range of skills. Learning outcomes: The reader will better understand (1) the parents' expectations for therapy (2) the types of changes that can be associated with speech and language therapy and (3) the need for broad-based outcome measures that can evaluate speech and language outcomes.