Findings from an Efficacy Trial of the First Step to Success Early Intervention Program In Preschool Settings

Background and Purpose: Many preschool and early childhood care settings are overwhelmed by increasing numbers of at risk children who are unresponsive to the minimal but necessary demands of schooling. The purpose of this study was to determine, via a randomized controlled trial, the efficacy of the Preschool Adaptation of the First Step to Success intervention (Walker, Kavanagh, Stiller, Golly, Severson, & Feil; 1998) as determined by improvements in child behavior and social skills outcomes of children who are at high risk for the development of oppositional and conduct disorders. First Step includes classroom and home components implemented over a 3-month period.

Methods: Efficacy was assessed by soliciting teacher and parents’ evaluations of positive changes in students’ social skills and problem behavior(s) using the Social Skills Improvement System. Study participants’ also completed assessments of the First Step’s intervention goals, procedures, and outcomes through satisfaction surveys and post-intervention focus group interviews. In fall 2009 and fall 2010, 39 classroom teachers at Community Action Head Start (Salem, OR) and Head Start of Lane County (Springfield, OR) and 43 teachers at Jefferson County Public Schools (Louisville, KY) consented to participate.  Teachers completed the Early Screening Project screening protocol (ESP; Walker, Severson, & Feil, 1995) to screen for children at risk for the development of behavior problems. Research staff recruited one nominated student from each classroom. After obtaining parent consent and completing baseline data collection, we randomized participants to an intervention or control condition. Thirty-nine control teachers received training in primary prevention strategies. Forty-two intervention teachers received the same training in primary prevention strategies as well as training in First Step to Success and assistance implementing the program from a behavioral coach. We found equivalence across most baseline measures with the exception of percent female and percent at risk on the Aggressive Behavior Scale.

Results: Based on teacher- report, children in the intervention condition had greater increases in social skills (d = .91) and decreases in problem behavior (d = -.95) than children in the control condition. Parents from the intervention group reported greater gains than parents in the control group in social skills (d = .58) and reductions in problem behavior (d = -.92) as well.

Conclusions and Implications: This study contributes to the growing literature base that provides preschool teachers and administrators with viable options to improve their students’ chances of later school success, and reduce the stress of their teachers. The home component of this intervention makes the First Step intervention a particularly good option for social workers practicing in school settings.