We describe a speech-language pathology and occupational therapy service delivery program for preschoolers with developmental delays and communication and related impairments. Key features included interprofessional collaboration; parent professional partnerships; naturalistic environment; opportunities for choice and control; use of a relationship-based approach; and communication, sensory, and positive behavioral strategies. Participants were 16 boys and 4 girls, ages 3 years, 2 months to 5 years, 8 months, who attended the program two mornings per week. Outcomes measured were pragmatic language and participation as well as parent satisfaction. Results indicated that children demonstrated significant improvements in pragmatics and participation and that parents expressed a high level of satisfaction. Children also achieved additional clinical objectives. Implications of findings are discussed.