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The objective of this study was to examine whether fine motor skills (FMS) and executive function (EF) are unique predictors of school readiness (SR). The sample was 108 preschoolers with externalizing behavior problems (EBP; Mean ± SD = 60.37 ± 3.94 months pre-intervention, 68% male) enrolled in a comprehensive 7-week school readiness summer program open trial. FMS were measured with the Learning Accomplishment Profile Diagnostic Third Edition (LAP-D); EF was measured with the Head–Toes–Knees–Shoulders (HTKS), and SR was measured with the Bracken School Readiness Assessment Third Edition (BSRA-3). All assessments were given pre- and post-intervention. All models controlled for participant age and socio-economic status (SES). Examining data pre-intervention, FMS but not EF uniquely predicted SR, explaining 46% of the variance. At post-intervention, both FMS and EF predicted SR, explaining 33% of the variance. These findings underscore the importance of screening both FMS and EF in preschoolers with EBP as they prepare to transition to kindergarten, as these domains both contribute to characterizing SR.

This study explored the associations between Adverse Childhood Experiences (ACEs) and functioning across several school readiness domains among preschoolers with disruptive behavior problems. The sample included 115 children (M age = 5.18, 67.8% male; 32.2% female) from a large, urban, high-poverty community, with predominantly Black families, who were about to enroll in a summer treatment program prior to kindergarten. As part of pre-treatment assessments, caregivers completed interviews and questionnaires about adverse experiences and stressors in their children’s lives. Children’s behavioral, academic, and social functioning were also assessed at this time. We identified exposure to ACEs using multimodal parent reports. A path analysis was conducted between preschoolers’ exposures to ACEs and their school readiness, covarying outcomes with one another to isolate the effect of ACEs. Our findings indicate a dose-effect, such that exposure to a higher number of ACEs is significantly associated with more severe disruptive behaviors, internalizing problems, and global impairment in the child’s functioning. However, there were no significant associations between total number of ACEs and academic or social functioning. Notably, the prevalence of ACEs among this sample of preschoolers living in highly under-resourced communities was strikingly higher than national samples, with 93.9% of parents reporting exposure to at least one ACE by age 5, compared to 19–26% in a nationally samples; moreover, 62.6% experienced 3 or more ACEs, compared to 5.35% in same-aged samples (Briggs-Gowan et al., 2010 ; Jackson et al., 2021 ). Our study contributes to the growing literature on the importance of recognizing the heightened risk of early and compounding adversity in school readiness outcomes for young children with special needs. Implications for early intervention timing and the need to consider readiness for preschool are discussed. Study Highlights We investigate associations between adversity and school readiness in preschoolers with disruptive behaviors living in a low income community. We identify exposure to ACEs using multimodal parent report from clinical interviews and surveys. We find that 94% of participants had experienced at least 1 ACE and 49% had experienced 4 or more. We find a dose effect between number of ACEs and severity of disruptive and internalizing problems, and global impairment.

The purpose of the study was to a) examine school readiness (SR) outcomes in preschoolers with externalizing behavior problems (EBPs) and language impairment (LI) after receiving an intensive multidisciplinary SR intervention and b) examine changes in language as predictors of improvements in SR treatment outcomes via an open trial design. Preschoolers (n = 91) with elevated levels of EBPs and comorbid LI (Mage=4.77, SD= .56, 76% male, 82% Hispanic/Latino) participated in an 8-week Summer Treatment Program for Pre-Kindergarteners and received speech therapy for 30 min/4 days a week. SR outcomes included language, behavioral, academic, social, and self-regulation measures. Paired sample T-tests revealed significant improvements across SR outcomes. Regression analyses demonstrated that changes in language were associated with changes in academic and executive functioning. Findings indicated that children with comorbid EBPs and LI made significant improvements across SR domains through a multidisciplinary SR intervention. Implications for early intervention for children with EBPs and LI, are discussed.

This study examined the role of callous-unemotional (CU) traits in preschoolers with externalizing behavior problems (EBP) and their response to time-out (TO). One hundred ninety preschoolers (76% boys, Mage = 4.92) with at-risk/clinically elevated levels of EBP participated in an 8-week summer treatment program (STP-PreK). Total number of minutes spent daily in TO for intentional aggression (IA) and repeated non-compliance (RNC) were recorded during the initial (T1) and final (T2) phases of the STP-PreK. After accounting for severity of EBP and levels of TO at T1, higher levels of CU traits predicted greater total levels of TO at T2. An interaction also emerged between symptoms of oppositional defiant disorder (ODD) and CU traits in predicting IA. Specifically, greater ODD symptoms predicted fewer number of IA related TO at T2, but only for children with low CU traits. Implications for treatment are discussed.

The purpose of this study was to examine how parental homework completion, session attendance, and treatment knowledge influenced parenting practices and confidence in using learned skills during behavioral parent training (BPT). Parents of 54 preschoolers (Mage = 5.07, 82% Hispanic/Latino) with externalizing behavior problems participated in an 8-week group BPT program. Pre-and posttreatment measures included parent-reported parenting practices and a treatment knowledge quiz. Parental homework completion, or home practice of skills, was reported by parents and collected weekly. Increases in positive parenting and decreases in negative parenting were observed (Cohen’s d = .63 and .70, respectively), as well as increases in treatment knowledge (d = 1.46). Treatment knowledge moderated the association between parental homework completion and negative parenting as well as parenting skill-use confidence. Increased parental homework completion was only associated with decreases in negative parenting and increases in skill-use confidence for families with high treatment knowledge. Parental homework completion also moderated the association between session attendance and negative parenting, such that lower session attendance was only associated with higher negative parenting for families that had low parental homework completion. Findings highlighted the potential impact that parents’ reports of home practice may have on improving parenting.

The purpose of the study was to identify profiles of social functioning for preschoolers with externalizing behavior problems (EBP) and examine how profiles are predictive of response to a behavioral treatment program. 139 preschoolers with EBP participated in an 8-week Summer Treatment Program for Pre-Kindergartners (STP-PreK). Latent profiles of social functioning were created from parent and teacher rated atypicality and social skills scales, along with child performance on an emotion knowledge and hostile attribution task. Baseline and treatment outcomes included behavioral, academic, and executive functioning measures. Latent profile analyses resulted in two profiles (e.g., average and low) marked by differences in social skills, emotion knowledge and rates of atypical behaviors. Children in the low social functioning group had higher teacher rated hyperactivity and attention problems at baseline (d = .44 & 1.07), as well as lower IQ (d = .39). Children in the low social functioning group also had poorer treatment response as they had lower executive functioning scores (β = −.17, p < .05) at the completion of treatment. IQ moderated the association between social functioning profiles and behavioral treatment outcomes, such that lower social functioning was only associated with higher rates of attention problems for children with average IQ. Findings highlight the differential impact of social functioning in predicting treatment outcomes.

The purpose of the current study was to examine the role of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) symptoms in predicting deficits in self-regulation across the domains of executive functioning and emotion regulation. Parents of 40 preschoolers with externalizing behavior problems reported on children’s ADHD and ASD symptoms, and emotion regulation. Children completed a standardized executive functioning battery. Results indicated that 28% of parents and 53% of teachers rated children above the subclinical range on ASD symptoms. An interaction emerged such that higher ASD symptoms were only associated with poorer executive functioning for children with lower ADHD symptoms. However, ASD symptoms were predictive of poorer emotion regulation independent of ADHD symptoms. Findings revealed clinically significant ASD symptoms, which aided in explaining heterogeneity in self-regulation deficits.

This study sought to examine parent perceptions of medication use for 151 preschool children (Mage = 5.05 years, 78% male, 82% Hispanic/Latino) with or at-risk for ADHD who were medication naive. Parents completed questionnaires regarding family background and perceptions of medication treatment. Parents and teachers completed ratings of child diagnostic symptomatology, behavioral functioning, and functional impairment. Results indicate that only 45% of parents were open to the possibility of medication. No associations were found between child demographics, severity of ADHD symptoms, or level of functional impairment and parental openness to medication. On the other hand, children of parents who were open to medication tended to have higher levels of oppositionality and aggression (as reported by parents but not teachers) compared with children of parents who were not open to medication. These findings are discussed in the context of early intervention given their implications for a variety of treatment providers.

The objective of this study was to evaluate two early intervention packages to promote successful transitions to kindergarten for preschoolers with behavior problems recruited from Head Start preschools. Fifty children (Mage = 61 months; 76% male; 98% minority) referred by teachers due to early externalizing behavior problems were randomly assigned to one of the two groups. Group 1 (high intensity; HI) received a 4-week intensive summer program before the start of kindergarten, weekly parent workshops, and monthly school consultation and parent workshops throughout kindergarten. Group 2 (low intensity; LI) received only parent workshops. Program feasibility, child improvement, and parental satisfaction data were collected along with parent and teacher reports and measures of school readiness. Children in the HI group demonstrated fewer problem behaviors and less student–teacher conflict as reported by teachers. Early intensive summer interventions prior to kindergarten were found to be a promising avenue to promote successful transitions to school for children from Head Start preschools with behavior problems.

Within an at-risk sample of preschoolers with externalizing behavior problems (EBP), the current study examined the initial promise of a multimodal intervention, the Summer Treatment Program for Pre-Kindergarteners (STP-PreK), in improving parenting outcomes. Using an open trial design, 154 parents and their preschool children (73% male; Mage = 5.06 years; 82% Hispanic/Latino background) with at-risk or clinically elevated levels of EBP (57% of which were referred by schools or mental health/medical professionals) completed a baseline and post-treatment assessment. A subsample of 90 families completed a follow-up assessment approximately 6 to 9 months after treatment completion. Parental measures of parenting stress and discipline strategies were collected across all three assessments. Observational data were also collected across all assessments during a 5-min standardized child-led play situation and a 5-min parent-led clean up task. The parenting component of the STP-PreK included a School Readiness Parenting Program (SRPP) of which the behavioral management component was implemented via a Parent-Child Interaction Therapy (PCIT) adaptation (8 weekly group sessions with 15–20 parents in each group, lack of requirement of “mastery” criteria). All parenting outcomes (both ratings and observed) significantly improved after the intervention (Cohen’s d mean effect size across measures 0.89) with all effects being maintained at the 6–9 month follow-up. These findings highlight the initial promise of our SRPP’s PCIT adaptation in targeting multiple aspects of parenting while yielding comparable parenting skills acquisition compared to traditional individual PCIT.