Introduction: Quality of life and functionality are relevant in an approach based on the biopsychosocial model. Therefore, the objective of this study was to assess the influence of clinical, sociodemographic, and functionality aspects on the quality of life of children and adolescents undergoing speech-language evaluation. Methods: This is a cross-sectional analytical observational study conducted with 84 Brazilian children and adolescents. The Brazilian Economic Classification Criteria and the Pediatric Quality of Life Inventory 4.0 were applied, and data were collected on sex, complaints, SPL diagnostic hypothesis, as well as on the Body Functions, Activities and Participation, and Environmental Factors components of the International Classification of Functioning, Disability, and Health (ICF). Factor analysis and structural equation modeling were used for data analysis, with a 5% significance level applied to the final models. Results: Male sex and clinical-care variables had a direct and negative influence on functionality in the first two models (p < 0.05). Activities and Participation had a positive direct effect on self-reported quality of life (p = 0.031; β = 0.282) and parent/caregiver-reported quality of life (p = 0.003; β = 0.387). Parent-reported quality of life was negatively influenced by complaints of orofacial motricity alterations, while self-reported quality of life was positively influenced by the diagnostic hypothesis of speech disorders. Conclusion: The results show that sex and clinical-care complaints negatively influenced functionality, while Activities and Participation positively influenced quality of life. The use of structural equation modeling proved to be an important strategy for analyzing ICF and quality of life in SLP practice.

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