Assessing communicative participation in preschool children with the Focus on the Outcomes of Communication Under Six: a scoping review

Aim: To describe uses of the Focus on the Outcomes of Communication Under Six (FOCUS) in research since its publication in 2010. Method: Six databases were searched for the term ‘Focus on the Outcomes of Communication Under Six’. With additional searches we ascertained 70 articles, of which 25 met inclusion criteria for full review and data extraction. Results: The FOCUS has been used in research across multiple countries, purposes, populations, contexts, and versions. Evaluative studies have described the development of children’s communicative participation skills and factors that impact development of communicative participation; the impact of specific interventions on communicative participation; how FOCUS captures change relative to measures of impairment; and how FOCUS performs when used at different intervals. Adaptations included use of the FOCUS as a descriptive or discriminative tool; use with children outside the validated age range; using select items; and use with typically developing children. Interpretation: FOCUS is used worldwide in research and practice, and much has been learned about children’s communicative participation. Future research is needed to explore the relationship between children’s impairments and their communicative participation, develop a FOCUS App, and develop and validate of a school-age FOCUS