Externalizing behavior problems are the most common referral for young child mental health services (Egger & Angold, 2006) and are associated with poor long-term outcomes (e.g., later conduct problems, peer conflict, social maladjustment, and high school dropout). Thus, early intervention for preschool children who are exhibiting behavior concerns is imperative for the prevention of more severe behavior problems. Interventions for young child behavior problems are typically aimed at improving parenting practices; however, children who are at-risk for the development of clinically significant behavior problems are likely to exhibit emerging (i.e., subclinical) levels of behavior during the preschool years. Therefore, there is potential for a brief, preventive method to reduce the need for more time and resource-intensive supports in the future. One way to develop a preventive approach to service delivery and improve outcomes for at-risk children is to adapt an evidence-based parent training intervention designed for children with significant behavioral concerns. Parent-Child Interaction Therapy (PCIT) is one such intervention that has particularly strong empirical support in the treatment of child behavior problems. The present study utilized a nonconcurrent multiple-probe across participants design to examine the fidelity, efficacy, and acceptability of a modified version of PCIT in increasing positive parenting skills and decreasing parent-rated child externalizing behaviors with four mothers and their preschool-aged children who demonstrated emerging problem behaviors. Results indicated that the intervention was implemented with excellent adherence (i.e., average = 97%). Visual analysis revealed at least three demonstrations of a treatment effect for all three positive parenting skills (i.e., improvement in Labeled Praises, Behavioral Descriptions, Reflections), as well as for a reduction in child behavior problems. Tau-U analyses indicated moderate to large effects for all four dyads' use of Labeled Praises, large effects for Behavioral Descriptions across three dyads, and a large effect for one dyad's use of Reflections. Large effects for a reduction in observed child behavior problems were found for two children, and standardized ratings of child behavior problems fell below the sub-clinical range for three children following intervention implementation. Additionally, mothers reported high levels of satisfaction with the intervention.
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