Co-Principal Investigator: Hill Walker

Long-Term Follow-Up Award: 3 Years (FY 2020–FY 2022), $1,261,392

Purpose: The purpose of this project is to replicate, via a randomized controlled trial, the efficacy of the preschool adaptation of the First Step to Success intervention for improving child behavior and social skills outcomes, as well as the overall school readiness, of preschool children who are at high risk for the development of oppositional and conduct disorders. There is a need to intervene early with young children who are exhibiting early signs of these disorders, before the severity and intensity of their problems increase. Results from a prior efficacy trial provide promising evidence that participating in Preschool First Step to Success (PFS) reduces children's problem behaviors and increases their social skills, and this project aims to replicate those findings with a diverse population of students.

Project Activities: In Years 1–3 of the study, 50 early childhood program centers across two sites serving low-income families were recruited into three cohorts. Early childhood program centers were randomly assigned to a PFS or control condition. A total of 160 low-income children, their families, and their teachers participated. In the fall of each year, teachers identified students in participating classrooms who exhibited serious externalizing behaviors. Baseline data collection was completed prior to randomization and outcome assessments were conducted at (1) post-intervention, (2) approximately 2 months after completion of the intervention, and (3) a year later.
To examine longer-term impacts of PFS, the research team received $1,261,392 in additional funding to collect follow-up data through third grade for all students.

Products: The products of this project will include evidence of the efficacy of PFS on student behavioral and school readiness outcomes for preschool children who are at high risk for the development of oppositional and conduct disorders. They will also include peer-reviewed publications and presentations.

Structured Abstract

Setting: The research is taking place in Head Start settings in Oregon and a variety of early childhood programs (e.g., Head Start, Early Childhood Special Services) in Kentucky.

Sample: From within 50 early childhood program centers, a total of 160 low-income preschool children (ages 3–4) with problem behaviors that put them at high risk for the development of oppositional and conduct disorders, the children's families, and their teachers participated in this study.

Intervention: The Preschool First Step to Success is based on the First Step to Success early intervention program developed originally for use with students in early elementary grades. The original intervention consists of three components, to which additional pieces were added for the preschool version. In the first component of PFS, universal screening, teachers screen all students to identify those with behavior problems. In the second component, the classroom intervention, a trained behavior coach works with participating students and their classroom peers, teachers, and parents over a 3-month period (with a booster session 1 year later) to teach appropriate social skills and behaviors. The preschool version also includes classroom management training for all teachers on positive behavior support (establishing clear expectations, teaching expectations, reinforcing expectations, minimizing attention for minor inappropriate behavior, and delivering clear consequences for unacceptable behavior) and coaching the entire class before working one-on-one with the target child. The target children receive individual rewards for acceptable behavior, as well as earn awards for the whole class (to keep the whole class motivated to participate). The final component, parent education called HomeBase, consists of a series of six weekly lessons in the home designed to enable parents and caregivers to build child competencies and skills in six areas that affect school adjustment and performance (sharing at school, cooperation, limit setting, problem solving, making friends, and developing confidence).

Research Design and Methods: This study used a cluster randomized controlled trial design that nests teachers and classrooms within early childhood program centers. A total of 50 early childhood centers across two states were randomly assigned to the PFS or control condition. PFS was implemented over a 3-month period, with a booster session implemented 1 year later with the children, their parents, and their teachers. Data were collected at baseline and approximately 2 months and 1 year after the intervention to determine the immediate and distal impacts of the intervention on child outcomes and examine potential moderating and mediating factors. With additional funding, the research team will examine longer-term impacts of PFS by collecting follow-up data through third grade for all participating children.

Control Condition: Children in the business-as-usual condition received instruction and services typically provided by the early childhood programs.

Key Measures: Child outcomes measures of behavior included the Social Skills Improvement System, the Child Behavior Checklist, the Student-Teacher Relationship scale, and a measure of relational aggression. Child academic outcome measures included the Preschool Early Learning Indicators (PELI) for preschool and the Dynamic Indicators of Basic Early Literacy Skills for elementary school. At preschool, classroom context was assessed with the Preschool-Wide Evaluation Tool and the Classroom Assessment Scoring System. Participating preschool teachers also completed a survey about classroom characteristics; instructional practices; teacher training, licensing, and experience; and self-reports of their skills in dealing with students with behavior problems. Additionally, preschool teachers completed a survey to assess intervention acceptability/relevance, feasibility, accessibility/support, and affordability. Moderators and mediators were measured through family reports on student and family demographics, services received, and parent involvement in the child's education. School records data are also being collected (e.g., school discipline, parent conferences, attendance). At each follow-up timepoint, a procedure called School Archival Records Search—which provides a template for the systematic coding, analysis, and aggregation of data from archival school records—is implemented to examine data on risk factors for behavior disorders over time.

Data Analytic Strategy: A mixed-model analysis of covariance (ANCOVA) approach will be used to examine differences between intervention and control groups at two time points on outcomes, process, and social validity measures. For analysis of data collected at more than two time points, such as the estimation of maintenance of intervention effects at the within-year follow-up and long-term follow-up assessments, random coefficient models (RCA), an extension of the mixed-model ANCOVA, are used. Both mixed-model ANCOVA and RCA account for the nesting of classrooms within buildings.

Related IES Projects: Early, Evidence Based Intervention for Severe Behavior Problems: First Step to Success (H324P040006); Early, Evidence-Based Intervention For Externalizing Behavior Problems in School: From Efficacy to Effectiveness of the First Step to Success Program (R324B060003); Enhanced First Step to Success: Improving School Readiness for Children with Disruptive Behavior (R324A090237); Efficacy of Enhanced First Step to Success Intervention for Tertiary-Level Students with Disruptive Behavior (R324A150179)

Products and Publications

Journal article, monograph, or newsletter

Feil, E. G., Small, J., Frey, A. J., Seeley, J., Walker, H. M. Golly, A., and Forness, S.R. (2016). Early Intervention for Preschoolers at Risk for Attention-Deficit/Hyperactivity Disorder: Preschool First Step to Success. Behavioral Disorders, 41(2): 95–106. doi:10.17988/0198–7429–41.2.95

Frey, A. J., Small, J., Feil, E. G., Seeley, J., Walker, H. M., and Forness, S. (2015). First Step to Success: Applications to Preschoolers at Risk of Developing Autism Spectrum Disorders. Education and Training in Autism and Developmental Disabilities, 50(4): 397–407. Retrieved from https://eric.ed.gov/?id=EJ1082560.