Teachers and teaching assistants from three Head Start classrooms implemented a multi-tiered narrative intervention in their preschool classrooms. They delivered large group, small group, and individual lessons with students and administered and scored a progress monitoring tool with all children once a month. A quasi-experimental control group design was conducted to determine the effect of the multi-tiered intervention on children's story retelling skills and story-based language comprehension. The extent to which the Head Start teachers' could deliver the intervention with fidelity and administer and score the progress monitoring probes accurately were examined. Feasibility data were collected via interviews and questionnaires. Results indicated statistically significant improvements favoring the treatment group at Winter and Spring assessment points for story retelling and language comprehension. All measures of teachers' fidelity and reliability were above acceptable standards. As teachers and teaching assistants became more comfortable delivering the intervention, teachers' perceptions of the intervention's feasibility increased.

This implementation study examined the efficacy and feasibility of a multi-tiered narrative intervention when Head Start teachers and teaching assistants delivered all of the interventions and progress monitoring probes. In six Head Start classrooms, 105 children were assigned to receive the intervention or to receive their typical instruction. Children who attended the three classrooms that implemented the multi-tiered intervention showed significantly better story retelling and language comprehension skills than the children who attended preschool in the control classrooms. Additional questions addressed the feasibility of a multi-tiered system in Head Start classrooms. Findings indicate that Head Start teachers and teaching assistants can deliver large group, small group, and individual lessons with ease; they can administer brief progress monitoring probes and score children's retells without great difficulty. After a few months implementing the new program, teachers and teaching assistants became more comfortable with the procedures and considered a multi-tiered system to be more doable in their classrooms