Early Intervention for Preschoolers at Risk for Attention-Deficit/Hyperactivity Disorder: Preschool First Step to Success.

Researchers tested Preschool First Step (PFS) in preschool classrooms. Kids were 3-5 years old and flagged for ADHD risk.

Teachers and parents filled out behavior checklists before and after the program. The study used a coin-flip design to pick who got PFS first.

Teachers saw big jumps in social skills and sharp drops in problem behavior. Parents saw medium-sized gains at home.

The program worked better at school than at home, but both settings improved.

Veenman et al. (2018) pooled 19 similar classroom trials. Their meta-analysis shows the same small-to-medium benefit PFS found, so the new result lines up.

Dzanko et al. (2026) trimmed the dose to just 3 hours a week and still saw gains for kids with developmental delays. PFS used more hours, but both studies say low-intensity ABA can work in preschool.

Eldevik et al. (2010) ran 10 hours a week of behavioral therapy for kids with intellectual disability and found large IQ and adaptive gains. PFS now shows the same kind of large classroom benefit, but for ADHD risk instead of ID.

You can pitch PFS to preschool directors as a ready-made classroom package. It needs no extra clinic room, just teacher coaching and brief parent sessions. Start with one teacher, track behavior with simple checklists, and you should see social skills climb and disruptions fall within eight weeks. If you serve kids who are too young for a full ADHD label but show red-flag behavior, this gives you an evidence-based option that fits right into circle time and recess.