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Problem behaviors in preschool‐aged children negatively affect teacher‐child relationships and children's skill development. In this clinical replication of an initial study, we implemented Teacher–Child Interaction Training (TCIT), a teacher‐delivered, universal intervention designed for early childhood settings. The initial study evaluated the TCIT program in a sample of 4‐ to 5‐year‐old children, whereas the current study focused on 2‐ to 3‐year‐old children. Teacher ratings of children's behavior indicated a significant main effect for time on children's protective factor scores, but not on behavioral concerns. However, for children whose ratings fell in the below‐average range at baseline, significant large effect sizes were obtained for changes over time for both protective factors and behavioral concerns. Higher levels of teacher skill change were significantly associated with overall higher protective factor scores, as well as lower behavioral concern scores for children when baseline levels of behavioral concerns were high. Results provide further support for the effectiveness of TCIT as a universal intervention designed to improve children's behaviors through targeted improvements in teachers’ relationship‐building skills and classroom management strategies.

The current review evaluates the use of treatment fidelity strategies in evidence-based parent training programs for treating externalizing disorders. We used a broad framework for evaluating treatment fidelity developed by the National Institutes of Health Treatment Fidelity Workgroup that includes the aspects of treatment design, treatment delivery, training providers, and assessment of participant receipt of treatment and enactment of treatment skills. Sixty-five articles reporting outcome trials of evidence-based parent training programs met inclusion criteria and were coded for treatment fidelity strategies. The mean adherence to fidelity strategies was .73, which was higher than two previous review studies employing this framework in the health literature. Strategies related to treatment design showed the highest mean adherence (.83), whereas training of providers and enactment of treatment skills had the lowest (.58). In light of an increasing emphasis on effectiveness and dissemination trials, the broader treatment fidelity framework as applied in this review focuses needed attention on areas often overlooked in fidelity practices, such as training providers and generalization of treatment skills. We discuss the strengths and limitations of fidelity practices in parent training studies, implications of these findings, and areas for future research.

Objective: Young children diagnosed with sickle cell disease (SCD) are at risk for neurocognitive delays. Traditional neurocognitive measures are not realistic for frequent, repeated screenings in a medical clinic setting. The current study sought to (a) examine the clinical utility of the Ages and Stages Questionnaire (3rd ed.; ASQ-3) for repeated developmental screenings in an integrated behavioral health model within a SCD specialty clinic and (b) highlight case examples of ongoing developmental monitoring. Method: Parents of 52 children aged 3 months to 4 years old were administered the ASQ-3. The ASQ-3 screener provides five domain scores (communication, gross motor, fine motor, problem solving, personal social), which translate into pass, at-risk, or fail categories using age-based cut-off scores. Families participated in three administrations in a SCD clinic. Results were used by an interdisciplinary team to inform patient care. Results: The majority of the sample (90% to 96%) screened in the passing category across domains at baseline. However, 17% to 30% of the sample had at least one at-risk or failing score in any one domain across administrations. Rates of passing scores declined by 5% to 17% across administrations. Problem solving and personal social domains showed the largest declines. Conclusions: Results of the current study supported utility of the ASQ-3 in this specialty clinic setting to detect children at risk for developmental delays. In a high-risk population such as SCD, repeated, prospective developmental screening of young children with a brief screening measure can detect those in need of developmental supports and allows for timely referrals to early intervention. Implications for Impact StatementChildren followed in a medical clinic for sickle cell disease (SCD) care participated in developmental screening with a psychology provider as a routine part of their medical visit. Most children (90% to 96%) passed the screener at their first visit. However nearly one third of the children had at least one at-risk or failing score in one of five developmental domains as they got older. Monitoring young children with SCD using a brief screening measure can identify children in need of developmental supports and help get them connected with early intervention and other developmentally supportive services.

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