Purpose: To explore the application of the Activities and Participation component of the International Classification of Functioning, Disability and Health - Children and Youth (ICF-CY, World Health Organization, 2007) as a framework for investigating the perceived impact of speech impairment in childhood. Method: A 32-item questionnaire based on six ICF-CY domains was distributed to (a) a national sample of speech-language pathologists (SLPs; n=205), and (b) parents (n=86) of preschool children identified with speech impairment. Results: Factor analysis of the SLP data revealed six coherent factors with moderate-high internal reliability: Verbal communication (e.g., Conversation, Speaking), Advanced learning (e.g., Learning to read/write), Interpersonal interactions (e.g., Relating with strangers, Informal social relationships), Basic learning (e.g., Copying, Rehearsing), Applied learning and general tasks (e.g., Focussing attention, Handling stress), and Non-verbal communication. The first five factors were also confirmed by the parent data. Both SLPs and parents rated the first two factors, Verbal communication and Interpersonal interactions, as the most difficult activities for children with speech impairment. Conclusion: The ICF-CY Activities and Participation component is a useful framework for considering the breadth of activities that may be impacted by speech impairment in childhood. Learning outcomes: (1) Discuss the potential use of the ICF-CY in speech-language pathology; (2) Describe the breadth of activities that may be difficult for children as a result of speech impairment; and (3) Recognize that SLPs and parents may have different perspectives regarding the impact of speech impairment on children's activities and participation.