Preschool Children with Challenging Behaviors: First Step to Success for Early Childhood

This presentation describes the results of an NICHD-funded grant to evaluate the efficacy of the preschool version of the First Step to Success early intervention. First Step is designed for at-risk, elementary school children who show signs of externalizing behavior patterns (Walker et al., 1997). The at-risk child is the primary focus of the First Step intervention; however, teachers, peers, and parents or caregivers participate in the intervention as implementation agents under the direction and supervision of a school behavioral coach who coordinates the intervention. The efficacy of the First Step intervention has been replicated repeatedly (Walker et al., 2009; Seeley et al., 2009; Loman, Rodriguez, & Horner, 2010); however, this is the first rigorous evaluation of the preschool version of the intervention. The preschool version of the First Step intervention includes several adaptations to address developmental differences between elementary and preschool children, including (a) classroom management training (b) increasing the coach’s time with the child, and (c) adaptations to the home component. 

Across the three cohorts, 138 of 149 consented teachers (92.6%) participated in the screening and student recruitment phase of the study. An adapted version of the Early Screening Project (ESP; Walker, Severson, & Feil, 1995) was used to identify one child with challenging behavior in each classroom. Following the screening procedures, we randomized 128 of the 149 recruited classrooms (85.9%) to either an intervention or comparison group condition following collection of baseline measures. Project staff collected implementation fidelity data, measures of teacher-coach alliance, estimates of student and parent compliance, measures of parent fidelity and dosage, as well as social validity data from participants assigned to the intervention condition.

Results demonstrate that coaches and teachers implemented the program as intended; teachers and coaches were satisfied with their working relationship as it pertained to program implementation; students and parents complied with program requirements; parents were involved and engaged in the homeBase component of the program; and teachers and parents were satisfied with program implementation, support, and outcomes. Additionally, pro-social and problem behavior scales, collected from teachers and parents for all children at pre- and post-test, indicate that children receiving the First Step intervention had significantly higher social skills, and significantly fewer behavior problems across a variety of teacher-and parent-reported measures. Specifically, Hedges' g effect sizes for the three pro-social outcomes ranged from .29 to .88.  Across the four outcomes in the problem behavior domain, children who received the First Step intervention had significant reductions in problem behavior across both school and home settings as compared to children who did not receive the program.