Efficacy of the Revised First Step Next Program in Preschool Settings: A Cluster-Randomized Trial

Background and Purpose: Disruptive behavior problems frequently emerge in the preschool years and can severely stress the classroom management skills of teachers. Disruptive behaviors are also associated with numerous, long-term negative outcomes for children. This presentation will report on an efficacy study (IES; R324A150221) of the revised and updated preschool version of the First Step Next intervention. FSN is a Tier 2 intervention that uses in-class coaching with teachers and direct instruction with children to address challenging or disruptive behavior patterns in school-based settings. The revised version of FSN preserves the core components (e.g., direct instruction, group and individual contingencies) of the original First Step to Success, a program with substantial empirical evidence supporting its efficacy. Revisions were made to the program to make it more user friendly and easier to implement with fidelity; to increase the instructional focus of the program; and to streamline parent involvement procedures.

Methods: This study utilized a cluster-randomized controlled design. Fifty preschool programs from four U.S. states were randomized to FSN (n = 25) or wait-list control conditions (n = 25). In total, 181 teachers participated in screening. One teacher-student-parent triad from 160 classrooms participated in the study (83 from classrooms in preschools randomized to FSN and 77 from classrooms in preschools randomized to wait-list control). In this presentation we will report the main effects of the program as well as fidelity, program compliance, therapeutic alliance, and satisfaction. We fit two-level random intercept regression models in Mplus 7.0 using a robust maximum likelihood estimator to account for missing data.

Results: Baseline teacher, parent, and child demographic characteristics were equivalent across conditions. Hedges’ g effect sizes for pro-social behavior ranged from .34 to .91. For Problem behavior, effect sizes ranged from .33 to .63. Teacher reported effects were higher (.33 to .91) than parent-reported effects (.34), suggesting the program was more effective on promoting pro-social and reducing problem behavior in classroom settings. FSN was also effective in reducing relational aggression (Hedges’ g = .41) and reducing child-teacher conflict (Hedges’ g = .80). Overall, adherence to program components was excellent for coaches and teachers; however, coaches implemented with higher quality than teachers, in general. Both coaches and teachers reported high levels of therapeutic alliance and satisfaction with program implementation.

Conclusions and Implications: This study adds to the accumulated literature base on First Step by providing empirical support that the revised program, with streamlined components to improve usability and satisfaction, retains its effectiveness in preschool settings. This study provides encouraging signs that coordinated adoption of evidence-based, Tier 2 programming can help reduce preschoolers’ challenging behaviors and, in turn, enhance the social and emotional well-being of preschool children struggling with disruptive behavior.